Racial Bias and Discrimination Negatively Impacts Heart Disease Care

Racial bias of ethnic minorities, specifically African Americans, factors into the decision-making process for approving patients with heart failure for heart transplants, according to the findings of two studies that were presented at the American Heart Association’s Scientific Sessions 2019.

In one study, researchers surveyed 422 physicians, nurses and other hospital decision-makers to determine bias by asking whether hypothetical black male and white male patients should be referred for a heart transplant after reviewing patient photos and other health information. Race was the only variant in this survey, with both hypothetical cases having identical medical and social histories.

The results of the survey showed that when questioned individually, the decision makers exhibited no differences in transplant recommendations. However, when a subgroup of 44 reviewers discussed the cases the researchers detected racial bias. These decision-makers perceived black patients as less healthy, less likely to comply with follow-up care recommendations and less trustworthy than their white counterparts. The reviewers were more likely to recommend black patients for ventricular assist devices than heart transplants. This bias was found to be especially true among health care providers older than 40.

In an unrelated study, researchers queried a cross-section of 395 African immigrants living in the Baltimore-Washington, D.C. metropolitan area. They found that participants who reported occurrences of racial discrimination were substantially more likely to have a higher risk of heart disease, and heart disease related factors.

“The most important thing is to recognize that implicit bias is real, and it’s pervasive and that clinicians really need to look within and really think about whether or not they have implicit biases and how those might be influencing their decisions,” said AHA volunteer expert Kiarri N. Kershaw, Ph.D., MPH in a press release. “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.”