Racial Bias Seen in Heart Transplants

By Robert Preidt
HealthDay Reporter

TUESDAY, Nov. 12, 2019 (HealthDay News) -- Racial bias among health care providers limits black Americans' odds of receiving a heart transplant, a new study finds.

Researchers asked 422 U.S. physicians, nurses and other hospital decision-makers to review the hypothetical cases of black men and white men with heart failure and to decide if the patients should be referred for a heart transplant.

The hypothetical cases had identical medical and social history. Race was the only difference among them.

Individually, there were few racial differences in participants' transplant recommendations.

But when a subgroup of 44 discussed the cases together -- more closely simulating how such decisions are actually made -- there was racial bias, according to the University of Arizona researchers.

In the group discussion, black patients were considered less healthy, less likely to comply with follow-up care recommendations and less trustworthy than white patients.

This meant that black patients were more likely to be recommended for mechanical pump devices instead of heart transplants, especially if the healthcare provider was older than 40.

The study is to be presented at the American Heart Association annual meeting, being held from Nov. 16 to 18 in Philadelphia, and will be published in the Journal of the American Heart Association.

"African-American race negatively influenced the decision-making process for heart transplants, especially during discussions among health care providers," lead author Dr. Khadijah Breathett said in an AHA news release. She's a cardiologist at the University of Arizona Sarver Heart Center in Tucson.

"Since advanced therapy selection meetings are conversations rather than surveys, race may contribute significantly to treatment recommendations," she added.

AHA expert Kiarri Kershaw called the study a strong and important one.

It is "really important for people, clinicians and others to really understand how implicit bias can kind of creep into decision-making, and how it can have an important impact on outcomes," she said.

"The first step is to be aware and acknowledge that you yourself might be biased, and these biases might be influencing you and try and seek ways to address it," she said.

Kershaw is an associate professor of preventive medicine at Northwestern University Feinberg School of Medicine in Chicago.

Both women are members of the AHA committees that study quality of care and social determinants of health.

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Sources

SOURCE: American Heart Association, news release, Nov. 11, 2019
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