It stands to reason that African-American men might be more willing to open up about their health concerns and seek preventive care if they are treated by black doctors.
But with the yawning gap between white physicians and those of color — only 4 percent of physicians in the United States are African-American — it’s not happening nearly as often as it should.
And that’s a shame. Because the results of a new clinical trial led by Marcella Alsan, MD, PhD, indicate that African-American doctors could help reduce cardiovascular mortality among black men — if there was more racial diversity among physicians. The work is featured in a Stanford Health Policy article.
After conducting a randomized clinical trial among 1,300 black men in Oakland, she found that the men sought more preventive services after they were randomly seen by black doctors for a free health care screening compared to non-black doctors.
“We found that, once African-American men were at the clinic, even though all services were free, those assigned to a black doctor took up more services,” such as flu shots and diabetes and cholesterol screenings, said Alsan, an economist and infectious disease physician who focuses on health and socioeconomic disparities here at home and around the world.
“It was surprising to see the results,” she said. “Prior to doing the study, we really were not sure if there would be any effect, much less the magnitude. The signal in our data ended up being quite strong.”
Those signals include the men were 29 percent more likely to talk with black doctors about other health problems and seeking more invasive screenings that likely required more trust in the person providing the service. They found subjects assigned to black doctors increased their uptake of diabetes and cholesterol screenings by 47 percent and 72 percent, respectively.
The researchers calculated that black doctors could reduce cardiovascular mortality by 16 deaths per 100,000 per year, accounting for 19 percent of the black-white gap in cardiovascular-related deaths. They believe that the results would be even larger if extrapolated to other leading causes of death that are amenable to prevention, such as cancer and HIV/AIDS.
“I was definitely surprised,” said co-author Owen Garrick, president and COO of Bridge Clinical Research, an Oakland-based organization that helps clinical researchers find patients from targeted ethnic groups. “If you ask most people, they feel that there is some impact of black men seeing black doctors — but it has never been quantified using an experimental design.”
The research by Alsan and Garrick, along with U.C. Berkeley graduate student Grant Graziani, appears in a working paper for the National Bureau of Economic Research.