Researchers in California found a more diverse physician workforce could improve health outcomes for minority populations, particularly black men, who have the lowest life expectancy of any demographic group in the U.S.
In a study of black male patients, researchers found the patients were more likely to agree to use preventive services if they saw a black physician than when they saw a physician of another race. The effect was even larger for invasive screenings that required a blood draw or injection. For example, 62 percent of the black men in the study agreed to undergo a cholesterol test when they saw a black male physician, compared to 36 percent who saw physicians of other races, according to the working paper, published by The National Bureau of Economic Research.
The study randomly assigned black male patients — who were recruited from barbershops and flea markets in Oakland, Calif., for a free health screening — to one of 14 physicians. Eight of the physicians were not black and six were black. Patients were asked before seeing a physician if they wanted any of five preventive services: a blood pressure measurement, BMI measurement, flu vaccine, diabetes screening or cholesterol test. Physicians were told to encourage patients to undergo all preventive services.
Patients rated all the physicians highly, regardless of race. However, the black physicians wrote more detailed notes, indicating more communication and trust between physician and patient. The researchers also found patients who reported distrust of the medical system or who had to endure greater "hassle costs" for the appointment were even more likely to participate in the preventive screenings if their physician was also black. Hassle costs included longer wait times or travel times to the clinic.
While the reasons for higher rates of mortality among black men are multifactorial, the researchers note higher rates of chronic disease like diabetes and hypertension among black men in the U.S. suggest at least some of the disparity is due to lack of preventive care. Based on their findings, the researchers estimate black physicians could reduce cardiovascular mortality by 16 deaths per 100,000 per year, which translates to a 19 percent reduction in the black-white male disparity in cardiovascular mortality.
Currently, 13 percent of the U.S. population is black, but only 4 percent of physicians are black, according to the report.
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