Invited Critique |

Racial Disparities in Abdominal Aortic Aneurysm Repair Among Male Medicare Beneficiaries—Invited Critique

James H. Black III, MD
Arch Surg. 2008;143(5):510. doi:10.1001/archsurg.143.5.510.
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In 1998, the Department of Health and Human Services adopted a goal of eliminating racial/ethnic disparities in health care by 2010 in 6 clinical areas, including the treatment of cardiovascular disease.1 As such, the article by Wilson et al is a report card for health care providers. These authors seek to define the magnitude of disparity in AAA repairs among black men vs white men within the Medicare population from 2001 to 2003. Because screening data within this population are yet to mature, Wilson and colleagues derive the AAA prevalence ratio among black men and white men from the ADAM Veterans Affairs Cooperative Study.2,3 Because there are obvious differences in the comorbidities of the Medicare population vs the VA population, the prevalence ratio must be considered an estimate. Nevertheless, because the risk factor profile within the ADAM trial between white men and black men is similar, it is unlikely that the derived AAA prevalence ratio is erroneous. So, if we accept that leap, and I believe we should, what does this article say about the current state of affairs 8 to 10 years into the federal mandate to alleviate racial/ethnic disparity in health care delivery?

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