Study: Black Men With Prostate Cancer More Likely To Get Worse Care Than White Men

A new study of men 65 or older with localized prostate cancer shows that black men may receive poorer care than white men in treatment for prostate cancer. (M. Spencer Green/AP)

A new study of men 65 or older with localized prostate cancer shows that black men may receive poorer care than white men in treatment for prostate cancer. (M. Spencer Green/AP)

Imagine you’re a 70-year-old black man with prostate cancer. Here’s what a new study reveals about your outlook:

You’re far more likely to get worse medical care than your white counterparts, including more time waiting for your surgery and more emergency room visits and hospital readmissions after surgery. You’ll also likely spend more money on your care. Oddly, though, that inferior care won’t necessarily translate into a worse chance of survival.

The study, published online by JAMA Oncology, specifically looked at a group of men on Medicare with localized prostate cancer. The standard of care for such patients involves either removal of the prostate gland (called a radical prostatectomy or RP), radiation therapy, a combination of the two, or active surveillance (close followup of patients).

Prostate cancer is one of the most frequently diagnosed cancers among men in the U.S., with estimates of about 220,800 new cases in 2015 and approximately 27,540 deaths.

Researchers analyzed data from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER)-Medicare database for 26,482 men 65 or older with localized prostate cancer who underwent radical prostatectomy. The patients included 2,020 black men (7.6 percent) and 24,462 non-Hispanic white men (92.4 percent).

Some key findings:

59.4 percent of black men underwent RP within 90 days vs. 69.5 percent of white men.

Black men had a seven-day treatment delay compared with white men in the top 50 percent of patients.

Black men were less likely to undergo lymph node dissection.

Black men were more likely to have postoperative visits to the emergency department or be readmitted to the hospital compared with white men.

The top 50 percent of black patients had higher incremental annual costs for surgery, spending $1,185 more compared to white patients.

I asked the study’s lead researcher, Quoc-Dien Trinh, M.D., of Brigham and Women’s Hospital in Boston and Harvard Medical School, to further explain the findings. Here, edited, is our conversation:

Rachel Zimmerman: What are the most extreme examples of disparities you found between black men and white men treated for prostate cancer?

Quoc-Dien Trinh: Blacks were 35 percent less likely to undergo surgery with 3 months of diagnosis; Blacks were 45-48 percent more likely to require a visit to the emergency department after surgery; Blacks were 28 percent more likely to be readmitted after surgery; Blacks were 24 percent less likely to undergo a lymph node dissection at prostatectomy.

How do you account for these dramatic differences in care?

It is possible that blacks are not receiving their care at the best institutions and/or with the best providers. Continue reading

Why Are 4 Out Of 5 Black Women Obese, Overweight?

This statistic, from a BU Today report on fighting obesity, is enough to ruin your morning: “No population in the United States has a higher obesity rate than African American women, four out of five of whom are overweight or obese, according to a 2012 study by the Centers for Disease Control and Prevention.”

No population has a higher overweight and obesity rate than African-American women (Spree2010/flickr)

The causes of this alarming obesity rate are various and complex and range from genes and diet to socioeconomic status and the environment, according to Julie Palmer, a senior epidemiologist at Boston University’s Slone Epidemiology Center who has coordinated the Black Women’s Health Study since 1995. In the BU piece, Palmer details some of these causes and potential fixes:

On Diet

“…when the women were asked how often they ate out and what type of fast food they chose—burgers, pizza, Mexican, Chinese, fried chicken, or fried fish—those who frequently chose the first option had the most consequences. “We found that eating burgers from fast food or other restaurants definitely increased risk for obesity,” Continue reading

Study: ‘Tableside Racism’ Persists In Restaurants


So much for our post-racial society.

A new report details the insidious racism that still pervades daily life in America, in this case the focus is “tableside racism” that plagues restaurants. The study by University of North Carolina researchers found that one-third of restaurant servers discriminate against African-American customers, with “substantial server negativity toward African Americans’ tipping and dining behaviors.” The report was published online in the Journal of Black Studies.

From the news release:

Researchers wanted to determine the extent to which customers’ race affects the way they are treated at restaurants, so the researchers surveyed 200 servers at 18 full-service chain restaurants in central North Carolina. The majority of the servers surveyed – approximately 86 percent – were white. Continue reading

Big Decline In HIV/AIDS Deaths Among Black New Yorkers

Getting an HIV/AIDS test

Good news on HIV/AIDS from the New York City Department of Health:

The Health Department today announced that new HIV data shows a 41% drop in deaths among black persons living with HIV/AIDS between 2001 and 2010. Despite this progress, black New Yorkers – representing 25% of the New York City population – disproportionately accounted for almost half of all new HIV diagnoses (48%) in 2010, a proportion that has remained almost unchanged for the past 5 years. Blacks were, however, more likely than all other racial/ethnic groups in the City to have had an HIV test in the past 12 months. To commemorate the 12th annual National Black HIV/AIDS Awareness Day today, the Health Department reminds all New Yorkers who do not know their HIV status to get tested for HIV, take the necessary precautions to stay negative and protect their partners, and get into treatment if you are positive. Continue reading