Blacks receive poorer health care than whites do. Studies have shown this time and time again.
Research now suggests that that these health care disparities do not stem from differences in access to care or the quality of health insurance, as some experts thought previously.
Researchers at Harvard and Brown universities say a racial gap persists in health care regardless of what health insurance plans people have, according to a study published in today's Journal of the American Medical Association.
Blacks still experience diminished health care when compared with whites, even when blacks are enrolled in "high-quality" health plans, plans in which a larger percentage of patients demonstrate signs of good health.
Poor health care often translates into poor health outcomes. But that cannot change until experts understand what's behind the disparities, experts say.
The Harvard/Brown researchers analyzed the blood sugar, cholesterol and blood pressure levels of more than 300,000 black and white patients. All were enrolled in one of 151 Medicare health plans in 38 states.
These weren't necessarily healthy patients -- they needed medical care.
At the start of the study, each patient had diabetes, high blood pressure or had suffered a cardiac problem, such as a heart attack or stroke.
Diabetes, high blood pressure and heart attacks can lead to stroke, kidney disease, heart attacks or death if not properly treated.
Proper treatment means keeping an eye on these high-risk patients to help them control their health problems. But black patients in the study were 6 to 14 percent more likely than white patients to have uncontrolled blood sugar, cholesterol and blood pressure levels.
Researchers found countless cases in which whites and blacks received different levels of care. Seventy percent of the time, those disparities occurred among white and black patients enrolled in the same Medicare plan.
"We saw that over two-thirds of the disparities were found within health plans and not between health plans," says Dr. John Ayanian, an author of the study and associate professor of medicine and health care policy at Harvard Medical School.
So these differences in quality of care have little to do with insurance and health care availability.
"Even when everyone is insured and in the same plan, we still find racial disparities," says Dr. Amal Trivedi, lead study author and assistant professor in the department of community health at Brown Medical School.
Experts say this study is important because "it pinpoints the problem," says Dr. Ross Isaacs, associate professor of medicine at the Center on Health Disparities at the University of Virginia.
"These disparities ... should not be underestimated."
Researchers hope their study findings will encourage health care organizations to start collecting data on race and ethnicity.
"There are no public reports of equity of health care. Many health care plans don't collect information on race and ethnicity," says Trivedi, which makes it difficult for health care plans to know when racial disparities exist.
With an increased awareness about racial disparities, heath care plans could then "monitor the quality of care their patients are receiving and have programs to improve this care when needed," says Ayanian, adding that the quality and the racial fairness of a given health plan should be taken into account when patients select a health plan.