Seeking Solutions for Health Disparities

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Advances in medicine and technology provide opportunities for millions of people to live longer, healthier lives – but only if they actually respond well to the therapies and can use them in ways that take into account their particular circumstances. Sadly, many people in certain racial and ethnic groups aren’t seeing the full benefits of healthcare advances. April is National Minority Health Month, an opportunity to shed light on this troubling issue, and to examine what can be done to address it.

You or someone you know may be among the roughly 80 million U.S. adults who have high blood pressure, which is a leading cause of heart disease and stroke. According to the American Heart Association, more than 360,000 American deaths each year, almost one thousand a day, include high blood pressure as a primary or contributing cause.

Fortunately, there are effective medications and lifestyle changes that help people to keep their blood pressure in a healthy range. These interventions have improved health outcomes associated with hypertension nationwide over the past several years. But these improvements have not been seen as much among minorities and rural populations.

Minorities have higher rates of hypertension and significantly higher rates of hospitalization due to hypertension. African Americans are nearly twice as likely to die from preventable heart disease and stroke as Caucasians. According to the Centers for Disease Control and Prevention, Hispanics have the highest percentage of uncontrolled blood pressure.

Although there has been significant investment to improve outcomes for all patients with high blood pressure, research suggests that these disparities have actually increased over the past few decades, suggesting that numerous unknown factors may be contributing to them. The Patient-Centered Outcomes Research Institute, or PCORI, aims to find solutions that can reduce these persistent health disparities and improve the ability of all individuals and families to live full, healthy lives. Through a partnership with the National Institutes of Health and the National Heart, Lung and Blood Institute, we are funding research out of Johns Hopkins University that examines the effectiveness of several health interventions for hypertension to determine which ones may prove most effective for individuals in different racial and ethnic groups.

We’re also supporting research of out of the University of Alabama at Birmingham focusing on African American populations in rural areas of the southeastern U.S. That research is analyzing whether peer coaches may be effective in helping minorities and others in rural areas diagnosed with hypertension manage or even improve their condition.

Hypertension is frequently called a “silent killer” because it often does not have any signs or symptoms. That makes opportunities such as Minority Health Month all the more important to start discussions about not just the conditions that impact minority populations, but also the potential solutions to addressing them.

Joe Selby, MD, MPH

View posts by Joe Selby, MD, MPH
Dr. Selby is a family physician, clinical epidemiologist, and health services researcher, Dr. Selby has more than 35 years of experience in patient care, research, and administration. He is responsible for identifying strategic issues and opportunities for PCORI and implementing and administering programs authorized by the PCORI Board of Governors. Dr. Selby joined PCORI from Kaiser Permanente, Northern California, where he was Director of the Division of Research for 13 years and oversaw a department of more than 50 investigators and 500 research staff members working on more than 250 ongoing studies. He was with Kaiser Permanente for 27 years. An accomplished researcher, Dr. Selby has authored more than 200 peer-reviewed articles and continues to conduct research, primarily in the areas of diabetes outcomes and quality improvement. Dr. Selby was elected to membership in the Institute of Medicine in 2009 and was a member of the Agency for Healthcare Research and Quality study section for Health Care Quality and Effectiveness from 1999 to 2003.
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