Originally posted 2011-01-24 12:37:53.
Obese black patients receive less weight reduction and exercise advice from doctors than obese white patients, a new study finds.
The researchers at the Johns Hopkins University Bloomberg School of Public Health also said they were surprised to find that white patients treated by black doctors were still more likely to receive weight and exercise counseling than black patients treated by black doctors.
“Our findings could be due to a number of factors such as negative physician perspectives towards black patients or a lack of sensitivity to the underlying levels of obesity risk for black patients as compared to white patients,” study author Sara Bleich, an assistant professor in the Department of Health Policy and Management, said in a university news release.
For this study, the researchers analyzed national data from 2,231 visits of black and white obese patients to their doctors. The findings appear in the January online issue of the journal Obesity.
“Previous studies have shown disparities in the proportion of black obese adults informed by physicians that they were overweight compared to white obese patients. We now also see that black patients are receiving different medical counseling as well,” senior author Dr. Lisa Cooper, a professor in the Department of Epidemiology and Health, Policy and Management, said in the news release.
“Further research is needed to understand how to improve obese patient counseling, particularly among the black population,” Cooper added.
In the United States, blacks have a much higher rate of obesity than other races, which puts them at increased risk for a number of chronic conditions such as diabetes, high blood pressure and heart disease.
Sorry for the sarcasm… or am I?
I mean, allow me to just shoot off the top of my head, for a moment.
If well over 2/3rds of African Americans can be classified as [at least] overweight, and overweight people have a tendency to fear going to the doctor because they don’t want to be confronted about their weight… is it that hard to believe that a doctor, one who is following this line of thought, might want to avoid the subject altogether to avoid losing a patient? And don’t get me wrong – that’s not in defense of the doctors by any means. That’s just a reality. A doctor’s office is a business just like any other, and they have to do what they have to do to keep patients.
Or…. if the assumption – made by the doctor – is that their Black patient won’t have the resources necessary to lose the weight (read: access to “healthy food,” money to purchase it… in other words, the doctor assumes the patient is poor because they’re Black), why even broach the subject? “I’ll only be telling them to do stuff that they can’t afford, anyway.”
And if that’s the case then, once again, healthy lifestyles are made out to be class issues… and class is lazily being determined by race. “If a person is Black, they must be poor.” Even if it weren’t about race, it’d still be about “you’re poor, you have limited resources, you couldn’t do it anyway” instead of “you have limited resources, but let’s see how we can use what you’ve got to get what you want.” (If you know where that quote comes from… I’m sorry. For both of us.)
And, as I found the press release for the study that came directly from Johns Hopkins itself, there’s something else that really should be paid close attention:
When it comes to advising obese patients, blacks receive less weight reduction and exercise counseling from physicians than their white counterparts. This is according to a recent study conducted by researchers at the Johns Hopkins Bloomberg School of Public Health who examined the impact of patient and doctor race concordance on weight-related counseling. The results are featured in the January 2011 online issue of Obesity.
“Contrary to our expectations, we did not observe a positive association between patient-physician race concordance and weight-related counseling,” said Sara Bleich, PhD, lead author of the study and an assistant professor with the Bloomberg School’s Department of Health Policy and Management. “Rather, black obese patients seeing white doctors were less likely to receive exercise counseling than white obese patients seeing white doctors. We also found that black obese patients seeing black doctors were less likely to receive weight reduction counseling than white obese patients seeing black doctors. This suggests that regardless of the physician’s race, black obese patients receive less weight-related counseling than white obese patients. Our findings could be due to a number of factors such as negative physician perspectives towards black patients or a lack of sensitivity to the underlying levels of obesity risk for black patients as compared to white patients.”
I’m not going to lie – my own experiences echo the findings of this study:
I remember being in high school.. and my doctor never – never – mentioned my weight. I can’t say, for sure, exactly why that was… but this very cheery, young, happy doctor would tell me “Well, you’re 215lbs, but that’s ok.. you’re just tall.” He wouldn’t look at last years chart to see whether or not I’d gained 20lbs in one year. He wouldn’t talk to me about food or activity levels at all. He’d just bypass the subject altogether.
I’d eventually go on to gain weight at a pretty ridiculous rate for the next few years.
How are we supposed to live healthier lives if our doctors fear even mentioning the problem to us? If they fear mentioning it to us, how are we ever supposed to find the answers we need to help us get there?
What are your thoughts? Let’s hear it!
PS: You know I’m looking for a copy of this study, right?
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