By Cara Murez
health day reporter
THURSDAY, March 2, 2023 (HealthDay News) — Older black men are more likely than others to die after surgery, a new study has found.
Black men have a higher risk of dying within 30 days of surgery than black women and white adults, and their risk of death after elective procedures is 50% higher than white men, the researchers found.
This may be due to the “unusually high cumulative amounts of stress” that black men face, contributing to their declining physical health, said researchers from the University of California, Los Angeles.
“Although enough is known about these inequalities, we find in our analyzes that it is specifically black men who die more, and they die more after elective surgeries, not urgent and emergent surgeries,” said the Dr. Dan Ly, study leader. He is assistant professor of medicine at the UCLA David Geffen School of Medicine.
It’s possible that black men suffer from poorer preoperative treatment of chronic conditions such as diabetes and high blood pressure, Ly said. Other possibilities for explaining the results include “delays in care due to structural racism and physician bias, as well as worse stress and its associated physical burden on black men in the United States,” Ly said in a press release from UCLA Health Sciences.
Using Medicare data from 2016 to 2018 for 1.87 million black and white Americans aged 65 to 99, researchers looked at outcomes after eight common surgeries.
These included repair of the abdominal aorta, appendectomy, cholecystectomy to remove the gallbladder, colectomy to remove all or part of the colon, coronary artery bypass surgery, hip replacement, knee and lung resection.
Some of these procedures were performed as emergency surgery and some as planned surgery.
The death rate after surgery in black men was about 3.05% compared to 2.69% in white men, 2.38% in white women and 2.18% in black women.
For elective surgeries, the mortality rate was 1.30% among black men, compared to 0.85% among white men, 0.82% among white women, and 0.79% among black women.
The researchers noted that the disparity between black and white men began as early as seven days after surgery. He still existed 60 days after the surgery.
Structural racism may partly explain these discrepancies, Ly said. Black neighborhoods are often near hospitals that lack quality resources such as specialists, including surgeons with advanced training. They also may not have the latest studies and diagnostic imaging tests.
Missing out on these benefits can lead to treatment delays leading to more advanced disease. It can also lead to more difficult surgeries.
The researchers also pointed to exposure to toxic hazards that can increase disease severity.
“These differences in neighborhood, home environment, and community resources may make it more difficult for black patients, on average, to recover at home and make postoperative clinic visits,” the researchers said. “Our finding that black men experience higher surgical mortality than other race and gender subgroups is troubling, and also translates to shorter life expectancies among black men more generally.”
Among the limitations of the study is that it focuses exclusively on black and white patients. It used data from paying Medicare customers, so may not apply to others.
The results of the study were published on March 1 in the journal BMJ. The study was funded by the US National Institute on Minority Health and Health Disparities.
The KFF organization has more on the disparities in health care for black Americans.
SOURCE: University of California, Los Angeles Health Sciences, press release, March 1, 2023