When it comes to advising obese patients, blacks receive less weight reduction and exercise counselling 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 counselling. 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 counselling,' 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 counselling than white obese patients seeing white doctors. We also found that black obese patients seeing black doctors were less likely to receive weight reduction counselling than white obese patients seeing black doctors. This suggests that regardless of the physician's race, black obese patients receive less weight-related counselling 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.'
Obesity is defined as having a body mass index (BMI) greater than or equal to 30 kg/m2 and is an important risk factor for mortality and morbidity. In the U.S., blacks are disproportionately affected by obesity and are at an increased risk for a number of chronic diseases associated with obesity, such as cardiovascular disease, hypertension and diabetes.
Researchers analysed National Ambulatory Medical Care Surveys (NAMCS) from 2005 - 2007, a nationally representative cross-sectional survey of physician office visits, among individuals ages 20 years and older. Using a sample size of 2,231 visits of black and white obese patients to their black and white physicians from the specialities of general/family practice and general internal medicine, Bleich and colleagues examined the relationship between doctor-patient race concordance and weight-related counselling (measured as weight reduction, diet/nutrition and exercise counselling). Logistic regression was used to model the outcome variables of interest. In addition, tests were used to statistically compare whether physicians of each race provided counselling at different rates for obese patients of different races.
'Previous studies have shown disparities in the proportion of black obese adults informed by physicians that they were overweight compared to white obese adults,' said Lisa Cooper, MD, MPH, senior author of the study and a professor in the Bloomberg School's Department's of Epidemiology and Health, Policy and Management. 'We now also see that black patients are receiving different medical counselling as well. Further research is needed to understand how to improve obese patient counselling, particularly among the black population.'