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Blacks, Twice More Likely Than Whites to Die of Severe Blood Infection

Hispanics, the less vulnerable group

By Stefan Anitei, Science Editor

5th of February 2008, 12:03 GMT

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Every race has a different gene pool impacting the vulnerability or resistance to various diseases. A new research published in the American Journal of Respiratory and Critical Care Medicine
shows that blacks are twice more likely to die of severe sepsis (a general blood infection connected to acute organ dysfunction) as compared to whites.

"The difference in incidence was evident by age 20 and continued throughout the adult lifespan. After accounting for differences in poverty and geography, black race remained independently associated with higher severe sepsis incidence," wrote lead author Dr. Amber E. Barnato of the Center for Research on Health Care at the University of Pittsburgh, and Dr. Sherri L. Alexander, of Genentech.

Instead, Hispanics had a lower rate of severe sepsis than whites.

The team made a population-based analysis of race-specific incidence and case fatality rates for hospital-based infection and severe sepsis in Florida, Massachusetts, New Jersey, New York, Virginia and Texas, comprising 71 million people. Demographic and socioeconomic information came from the 2000 U.S. Census.

"Blacks do indeed have a higher rate of severe sepsis--almost double that of whites. Some, but not all of this increase was explained by blacks' more frequent residence in ZIP codes with higher poverty rates, suggesting that social, rather than biological determinants, such as health behavior and access to primary care, may contribute to this disparity. In contrast, Hispanic ethnicity appeared protective, conditional on similar regional urbanicity and poverty," wrote Barnato.

Besides differences in racial susceptibility to diseases, the researchers also considered various infections or organ dysfunction, and overall health.

"However, the severe sepsis syndrome characteristics were not markedly different among the groups with respect to the site of infection, microbiologic etiology and both the number and type of organ dysfunction. The burden of chronic conditions among severe sepsis cases did not differ substantially across racial groups," wrote Barnato.

One biasing factor could also be the hospital: blacks were more likely to receive treatment in hospitals with poorer results for severe cases of sepsis compared to whites.

"If a black and white patient with the same clinical characteristics were treated at the same hospital, they would have identical case survival rates. Therefore, it may be that the hospitals that treat most black patients see black and white patients who are sicker than we can measure using these data sources, and/or that these hospitals are providing lower quality care," said Barnato.

The research also could not adjust for factors like behavior, pharmaceutical use, healthcare resources.

"The overall mortality disparity among blacks could be partially ameliorated by focused interventions to improve processes and outcomes of care at the hospitals that are disproportionately black," concluded Barnato.

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blood | infection | inflammation
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