Heart Biases That Can Kill
Millions of Americans experience heart attack symptoms each year. So why do some get better treatment than others?
Different Symptoms? continued...
For instance, when women have a heart attack, they often complain of back pain, not chest pain. "So physicians may not clue into heart disease as quickly with a woman as when men come in complaining of chest pain," he says.
Minorities have also been found to downplay their pain as compared with whites. "You get a black man in the emergency room and ask him what's wrong, and he'll say, 'I have some indigestion,'" says Curry. "He has no idea he may be having a heart attack. Many minorities, as well as women, I think, are more likely to mistakenly think you have to have chest pain to be having a heart attack."
Still, doctors get their share of blame, says Curry, who served as Howard's chief of cardiology and in 1999 was named the American Heart Association's "Physician of the Year."
"I think there is probably a bit of unconscious prejudice going on that may explain why there's a better level of care given by doctors if you're white, male, and well-incomed than if you're a minority, female, or poor," he tells WebMD.
He cites one event two decades ago when the 70-year-old mother of one his staff members developed heart disease. "After learning about her condition, it was my estimation that she needed a pacemaker," says Curry.
But the woman wasn't getting one from her doctor. "The reason I was given by her doctor was that she was old and didn't have long to live. We talked about it and she did get her pacemaker. That was 20 years ago, and she's still living. But I believe because she was an old black woman, she would have died if I hadn't intervened and the doctor had used his normal instinct. I think if she were white she would have gotten the pacemaker sooner."
That "instinct" may result from past medical training, he says.
"There was a time when physicians were taught in medical school that blacks do not usually have heart attacks, so some of these treatment inequities may be a holdover from that," Curry tells WebMD. "Of course, they don't teach that anymore, since it's the most common cause of death among African Americans."