Wide Disparities Found in Age of Hospitalization for Patients of Different Races

New research from Yale School of Public Health shows that blacks are admitted to the hospital at a significantly younger age than their white peers for a host of preventable medical conditions, an indication that they have received inadequate care for the underlying conditions in the years leading up to their hospitalization. The study appears online this week and will be published in the January issue of the American Journal of Preventive Medicine.

The researchers examined discharge records for 6,815 white and black adult patients at nearly 500 hospitals. They found wide age disparities for a range of acute and chronic health conditions, including diabetes, pneumonia and high blood pressure.

After factoring in insurance and other variables, the research team led by Jeannette R. Ickovics, Ph.D., found that blacks were hospitalized, on average, five and a half years earlier than their white peers suffering from the same conditions. Black adults were hospitalized an average of nine years earlier than whites for all health conditions combined.

The biggest differences were found in uncontrolled diabetes (a 12-year age disparity) and bacterial pneumonia (7.5 years). A dozen diseases were measured, and significant disparities were also found for hospitalization with chronic obstructive pulmonary disease, congestive heart failure and dehydration.

“While the younger age at hospitalization was not necessarily surprising, the magnitude of the difference was indeed surprising,” said Ickovics, a professor at the Yale School of Public Health and director of CARE: Community Alliance for Research and Engagement. “Consider the direct and indirect health and economic consequences of hospitalization for uncontrolled diabetes at age 46 for a black man compared to age 58 for a white man.”

While previous studies have identified racial differences in rates of hospitalization, health status, health care access and disease burden, this is believed to be the first study to identify racial disparities in the age of adults at the time of hospitalization.

Lead author Katie Brooks Biello, a doctoral student at Yale School of Public Health, believes that preventive care for these conditions would reduce the need for hospitalizations. “Individuals who receive adequate and timely ambulatory care for conditions such as diabetes would not need to be hospitalized as early due to complications and a worsening in severity of these conditions,” she says. “A delay in hospitalizations would reduce social and economic burdens on individuals, families and society as a whole.”

The study team also included James Rawlings and Rosa Browne, both from the Department of Community Health at Yale-New Haven Hospital, and Amy Carroll-Scott of the Center for Interdisciplinary Research on AIDS.