Racial differences in cardiac catheterization as a function of patients' beliefs.


Journal Article

OBJECTIVES: We examined racial differences in cardiac catheterization rates and reviewed whether patients' beliefs or other variables were associated with observed disparities. METHODS: We did a prospective observational cohort study of 1045 White and African American patients at 5 Veterans Affairs (VA) medical centers whose nuclear imaging studies indicated reversible cardiac ischemia. RESULTS: There were few demographic differences between White and African American patients in our sample. African Americans were less likely than Whites to undergo cardiac catheterization. African Americans were more likely than Whites to indicate a strong reliance on religion and to report racial and social class discrimination and were less likely to indicate a generalized trust in people but did not differ from White patients on numerous other attitudes about health and health care. Neither sociodemographic or clinical characteristics nor patients' beliefs explained the observed disparities, but physicians' assessments of the procedure's importance and patients' likelihood of coronary disease seemed to account for differences not otherwise explained. CONCLUSIONS: Patients' preferences are not the likely source of racial disparities in the use of cardiac catheterization among veterans using VA care, but physicians' assessments warrant further attention.

Full Text

Duke Authors

Cited Authors

  • Kressin, NR; Chang, B-H; Whittle, J; Peterson, ED; Clark, JA; Rosen, AK; Orner, M; Collins, TC; Alley, LG; Petersen, LA

Published Date

  • December 2004

Published In

Volume / Issue

  • 94 / 12

Start / End Page

  • 2091 - 2097

PubMed ID

  • 15569959

Pubmed Central ID

  • 15569959

International Standard Serial Number (ISSN)

  • 0090-0036

Digital Object Identifier (DOI)

  • 10.2105/ajph.94.12.2091


  • eng

Conference Location

  • United States