Racial Differences in Mortality Among Men Hospitalized in the Veterans Affairs Health Care System

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Abstract
There are racial differences in many aspects of health care delivery.1-8 For example, black patients are less likely to receive coronary angiography after myocardial infarction than white patients9,10 and after receiving coronary angiography, they are less likely to undergo revascularization.11,12 Physicians are more likely to delay referrals to nephrologists for black patients than for white patients,13 blacks are less likely to receive surgery for lung cancer,14 and black women are less likely to undergo mammography than white women.15 Most,6,16-23 but not all,9,24-28 studies have demonstrated poorer outcomes for blacks. A few studies have even found improved clinical outcomes for blacks compared with whites29,30; for example, while blacks who have had renal transplantation have higher rates of graft rejection than whites,21 blacks undergoing hemodialysis have better survival rates than whites.31