Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Clinical pearls: Addressing health care disparities for African Americans

Pri-Med
Sponsored
November 30, 2020
Share
Tweet
Share

This article is sponsored by Pri-Med.

Gregory L. Hall, MD, an expert on African American health care, continues to draw interest and accolades from primary care audiences nationwide for his new CME web series, Bridging the Gap: Conversations with Dr. Hall, on Pri-Med.com. In each monthly episode, Dr. Hall hosts important discussions on health equity and social determinants of health, while focusing on evidence-based strategies to improve clinical care in African Americans.

Included in this review are takeaways from the first four episodes of Dr. Hall’s landmark CME series.

Episode 1 | Introduction to Patient-Centered Clinical Care for African Americans

  • Life expectancy for African Americans is below that of Native Americans, White Americans, Hispanic/Latino Americans, and Asian/Pacific Islander Americans
  • Compared to other races and ethnicities, African Americans exhibit worse outcomes in many diseases (e.g., cardiovascular disease, diabetes) and cancers (e.g., lung, breast, ovarian, cervical, colon, prostate, pancreatic, liver, thyroid, and head and neck)
  • Health disparities among African Americans are due to a variety of factors, including access to care, genetic/epigenetic, patient-related, provider/system-related, and oppression
  • Historical and cultural differences lead to mistrust between African Americans and the medical community

Episode 2 | Cardiovascular Disease and Patient-Centered Care for African Americans

  • Across nearly every metric, African Americans have poorer overall cardiovascular health than do non-Hispanic Whites
  • Compared to non-Hispanic Whites, African Americans have 1.4 times the risk of hypertension, 1.5 to 2 times the risk of coronary heart disease, 2 times the risk of heart failure, and 3 to 4 times the risk for stroke
  • African Americans are less likely to achieve blood pressure control than are non-Hispanic Whites
  • ACE inhibitors and ARBs are less effective in African Americans for blood pressure control
  • African Americans have much lower NT-pro-BNP levels, and therefore early heart failure could exist in the presence of “normal-looking” levels
  • African Americans have a 41 percent lower risk of being diagnosed with atrial fibrillation than do non-Hispanic Whites
  • Warfarin-dose requirements vary across racial/ethnic groups, with African American patients requiring a higher dose than Whites to maintain a therapeutic INR
  • African Americans have more favorable lipid profiles than matched White Americans, including having higher HDL cholesterol levels, lower triglyceride levels, and lower LDL cholesterol levels
  • African Americans have a salt-sensitive gene that may make hypertension worse
  • 75 percent of all African American patients with hypertension are salt sensitive, compared to 50 percent across all races with hypertension
  • African Americans showed the most pronounced blood pressure reductions in response to salt restriction, with a drop of 8 mm Hg systolic over 4 mm Hg diastolic averaged across an array of studies

Episode 3 | Obesity & Diabetes: Patient-Centered Clinical Care of African Americans

  • African Americans have a significantly increased rate of obesity, which directly correlates with an increased risk for chronic illnesses
  • African American women have a higher prevalence of obesity and are at a greater risk for weight management problems
  • African American children with obese parents are 10 times more likely to be obese
  • African Americans are 80 percent more likely to be diagnosed with diabetes type 2 than are White Americans, and are also diagnosed at an earlier age
  • The HbA1c value in African Americans essentially equates to a 0.4 percent difference (higher) for glucose-matched White patients
  • African American patients with sickle cell trait have lower HbA1c at any given level
  • HbA1c is not reliable in patients with sickle cell disease or thalassemia
  • African Americans should be encouraged to stop smoking, as smoking increases the risk of diabetes in this population

Episode 4 | Cancer Screening & Hematology: Patient-Centered Clinical Care of African Americans

  • Encourage the use of pharmacotherapy in smoking cessation rather than quitting cold turkey, particularly with menthol smokers
  • Perform annual lung cancer screening with low dose CT in adults aged 55 to 80 years who have a 30-pack per year smoking history and currently smoke or have quit within the past 15 years
  • Begin colon cancer screening among African Americans at age 45 and avoid sigmoidoscopies due to an increased prevalence of right-sided polyps and tumors
  • Screen African American men with an annual PSA and be aware that levels above 2 convey increased risk as well as accelerating increases within the normal range
  • The PSA test is a better and more sensitive detector of prostate cancer in African Americans, and at any given PSA level they are at a higher risk for prostate cancer than are White Americans
  • African Americans may have significantly lower values in WBC, neutrophil count, monocyte count, and platelets
  • African Americans may have significantly lower values in hemoglobin (HGB), hematocrit (HCT), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC)
  • Benign ethnic neutropenia (defined as between 1.0 × 109 cell/Liter and 1.5 × 1009 cell/Liter) has increased prevalence in African American patients
  • African Americans may have lower TSH levels with a range of 0.37 – 3.46 mIU/L (compared to “overall” reference interval 0.512 – 5.22 mIU/L)
  • The lipid profile in African Americans is generally more favorable with a higher HDL and lower total cholesterol, LDL, and triglycerides
  • Subtract 0.4 from the HbA1c in African Americans

Learn more about Dr. Hall

Dr. Hall is associate professor in integrative medical sciences and internal medicine at Northeast Ohio Medical Center and assistant clinical professor in medicine at Case Western Reserve University School of Medicine. He is also the director of the Institute for African American Health in Cleveland, OH, and recently authored Patient-Centered Clinical Care for African Americans: A Concise, Evidence-Based Guide to Important Differences and Better Outcomes.

View all episodes of Bridging the Gap to hear directly from Dr. Hall and earn CME credits at no cost.

Free CME/CE from Pri-Med

Join your clinician colleagues this week for PrimaryCareNOW on Thursday−Saturday, December 3−5. This free virtual conference, during which you can earn up to 19.00 CME/CE credits, includes brand-new courses on a wide range of primary care topics, including COVID-19, influenza, pain management, and more.

Your free registration includes access to inspiring keynote addresses from Drs. Sanjiv Chopra, Frank J. Domino, and Daniela Lamas. Sign up now.

ADVERTISEMENT

Prev

How this physician's first experience with death affected her [PODCAST]

November 29, 2020 Kevin 0
…
Next

Heartland parenting complicated by COVID

November 30, 2020 Kevin 5
…

Tagged as: Primary Care

Post navigation

< Previous Post
How this physician's first experience with death affected her [PODCAST]
Next Post >
Heartland parenting complicated by COVID

ADVERTISEMENT

More by Pri-Med

  • The top 5 reasons to attend live, virtual CME/CE

    Pri-Med
  • Primary care pearls from trending CME/CE courses on Pri-Med.com

    Pri-Med

Related Posts

  • How social media can help or hurt your health care career

    Health eCareers
  • Turn physicians into powerful health care influencers

    Kevin Pho, MD
  • Why eliminating health care disparities is easier said than done

    Martin Lustick, MD
  • Why health care replaced physician care

    Michael Weiss, MD
  • The role of medical education in perpetuating health care disparities

    Anonymous
  • Health care is not a service commodity

    Peter Spence, MD, MBA

More in Sponsored

  • Expert Q&A: Dr. Jared Pelo, ambient clinical pioneer, explains how Dragon Copilot helps clinicians deliver better care

    Jared Pelo, MD & Microsoft & Nuance Communications
  • Disability insurance done right: the financial lifeline every physician needs

    The Podcast by KevinMD
  • The buzz around GSI disability insurance for residents: Why it’s gaining popularity and how to take advantage

    Set for Life Insurance
  • Why your disability insurance agent might not offer the most optimized policy

    Set for Life Insurance
  • Patient safety in focus: Helping to address risk factors associated with non-ventilator hospital-acquired pneumonia

    Stryker Oral Care & The Podcast by KevinMD
  • Strategies for patient-centered and employee-focused care

    NRC Health & The Podcast by KevinMD
  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why so many doctors secretly feel like imposters

      Ryan Nadelson, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Why so many doctors secretly feel like imposters

      Ryan Nadelson, MD | Physician
    • Why telling kids to eat less and move more fails to address obesity

      Callia Georgoulis | Conditions
    • Why enterprise risk management is key to value-based health care success

      Olumuyiwa Bamgbade, MD | Physician
    • Rethinking physician resilience for sustainable well-being

      Sarah Webber, MD | Physician
    • How shared language saved a patient from isolation

      Syed Ahmad Moosa, MD | Physician
    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why so many doctors secretly feel like imposters

      Ryan Nadelson, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Why so many doctors secretly feel like imposters

      Ryan Nadelson, MD | Physician
    • Why telling kids to eat less and move more fails to address obesity

      Callia Georgoulis | Conditions
    • Why enterprise risk management is key to value-based health care success

      Olumuyiwa Bamgbade, MD | Physician
    • Rethinking physician resilience for sustainable well-being

      Sarah Webber, MD | Physician
    • How shared language saved a patient from isolation

      Syed Ahmad Moosa, MD | Physician
    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Clinical pearls: Addressing health care disparities for African Americans
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...