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Stories for Reprint
Minorities Have Fewer Hip and Knee Surgeries
By Ferdous Al-Faruque, MARRTC Staff
Age and race can factor into whether people have hip and knee surgeries due to arthritis, report researchers at Northwestern University in Chicago.
Hip and knee surgeries are most often recommended to people who have severely damaged knees and hips due to arthritis. Dorothy Dunlop, associate professor at Northwestern University and the principal investigator of the study, says generally minorities tend to under-use health services. "Hip and knee surgery is effective in reducing disability and we need to find ways to help minorities get access to these procedures," she says.
Dunlop and fellow researchers analyzed medical data for thousands of Americans 51 years and older from 1998 to 2004. They found that Hispanics regardless of age had far fewer hip and knee surgeries compared to whites. "A large portion of underutilization among Hispanics could be explained by having less income and education compared to white adults," says Dunlop. Many Hispanics may be unable to afford the costs associated with hip and knee surgeries or loss of wages during recovery. For many of them the short-term economical problems they may face from the surgery often outweigh the long-term benefits of improving their health.
The study also found that blacks younger than 64 had hip and knee surgery at a rate similar to their white counterparts, but after age 64 far fewer of them had surgeries compared to whites. Dunlop says there are several factors that may help explain why younger blacks were more likely to have the surgeries compared to older blacks. She says blacks tend to have higher obesity rates, especially younger blacks. "It could be that higher obesity in younger blacks leads to more joint damage and means they need hip and knee surgeries more," says Dunlop. "Younger blacks may (also) be more comfortable with surgical procedures."
Dunlop says more research needs to be done to understand why younger blacks are more likely to undergo hip and knee surgery than older blacks. "It's evident that older black Americans with severe joint damage could be excellent candidates for these surgeries," she says.
According to Dunlop the broader issue is to find ways to make the health care system accessible to everyone and reduce the cost of health care on the American taxpayers. Past research has found hip and knee surgeries can improve people's lives by reducing their disability, which in turn reduces the cost of health care. "If you are trying to have an equitable health care system, it's key to pull in the belt on excess costs of disability," says Dunlop.
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