Racial disparities within the U.S. health system are estimated to account for more than 83,000 deaths and an average of more than $57 billion per year and that disparities in outcomes persist in minority populations, even with the passage of the Affordable Care Act and an increase in insurance coverage and access to care.
Racial disparities are not present among military members and their dependents, a testament to the equality that exists in the armed services, suggested a recent longitudinal analysis published by researchers at the Uniformed Services University of the Health Sciences (USU) online in the Journal of Trauma and Acute Care Surgery
‘Racial disparities are not present among military members and their dependents, a testament to the equality that exists in the armed services.’
The first of its kind to find such data, the analysis was a collaborative effort between USU and Brigham and Women's Hospital in Boston, Mass. They analyzed five years (2006-2010) of TRICARE data, which provides health care insurance to the military, retirees, and their beneficiaries. In particular, they looked at Emergency General Surgery (EGS) conditions. These include a wide spectrum of procedures for the upper and lower gastrointestinal tract, pancreatic disease, soft tissue infections, and hernias, primarily because of their emergent nature, which are thought to lessen subjective external factors.
They looked at mortality, major morbidity, and readmission rates for more than 101,000 EGS patients representing four racial groups (White, Black, Asian, or Other), a population which is broadly representative of the insured American public. They found no differences in mortality and readmission rates at 30, 90 or 180 days for patients across racial groups, and only minimal differences in major morbidity between black and white patients. These findings are a stark contrast to the gaping disparities which have been demonstrated among those in the general (civilian) population.
"This is the first in a series of disparities studies using data from the Military Health System. We and our partners from Brigham and Women's Hospital are seeing that this equity in care within the MHS is potentially a model for the nation," said USU's Tracey Perez Koehlmoos, associate professor of Preventive Medicine and Biostatistics at the F. Edward Hobert School of Medicine. Koehlmoos is the principal investigator of the Comparative Effectiveness and Provider Induced Demand Collaboration (EPIC Project), which is funded by the Defense Health Agency.
"We hope that these findings will inform policy decisions both inside and outside the Department of Defense," added Air Force Lt. Col. (Dr.) Peter Learn, assistant professor of Surgery at USU. "In the meantime, we look forward to continuing this collaboration, and working to better understand the impact that universal insurance has for racially diverse patients."