Ethnic Differences in Satisfaction and Quality of Life in Veterans with Ischemic Heart Disease

Studies have indicated that African Americans, in comparison with Whites, receive less intense management of ischemic heart disease, even in the health system of the federal Department of Veteran Affairs (VA), where disparities due to socioeconomic factors would likely be less influential. Prior studies of these disparities have relied on administrative data. A new study collected data directly from patients in a primary care setting. Researchers surveyed 7,985 patients (6,704 Whites and 1,281 African Americans) at six VA medical centers throughout the U.S., who reported ischemic heart disease on a screening questionnaire. African-American patients reported higher levels of smoking, diabetes, hypertension and other risk factors than did Whites. At the same time, they also reported better physical function, vitality and angina stability. African-American patients were significantly less satisfied with the care of their disease than were White patients. However, after adjustment for socioeconomic factors and comorbidity, this disparity of satisfaction was not consistent across all sites. The researchers suggest that, in a system where ability to pay is not a factor in receiving care, ethnicity may not determine satisfaction with care. Other sociodemographic variables may be important as well.