Racial Disparities in Infection and Sepsis: Does Biology Matter?

  • F. B. Mayr
  • S. Yende
  • D. C. Angus
Conference paper


Health disparities refer to preventable differences in the indicators of health for different population groups. The National Institutes of Health (NIH) define disparities as differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups. Many groups all over the world are affected by disparities, including racial and ethnic minorities, older adults, children, women, and residents of rural areas.


Racial Difference Isosorbide Dinitrate Chronic Disease Burden Biology Matter Forgo Care 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Council of Ethical and Judicial Affairs (1990) Black-white disparities in health care. JAMA 263:2344–2346CrossRefGoogle Scholar
  2. 2.
    Bradley EH, Herrin J, Wang Y, et al (2004) Racial and ethnic differences in time to acute reperfusion therapy for patients hospitalized with myocardial infarction. JAMA 292:1563–1572PubMedCrossRefGoogle Scholar
  3. 3.
    Todd KH, Samaroo N, Hoffman JR (1993) Ethnicity as a risk factor for inadequate emergency department analgesia. JAMA 269:1537–1539PubMedCrossRefGoogle Scholar
  4. 4.
    Jazieh AR, Buncher CR (2002) Racial and age-related disparities in obtaining screening mammography: results of a statewide database. South Med J 95:1145–1148PubMedGoogle Scholar
  5. 5.
    Schneider EC, Cleary PD, Zaslavsky AM, Epstein AM (2001) Racial disparity in influenza vaccination: does managed care narrow the gap between African Americans and whites? JAMA 286:1455–1460PubMedCrossRefGoogle Scholar
  6. 6.
    Tamayo-Sarver JH, Hinze SW, Cydulka RK, Baker DW (2003) Racial and ethnic disparities in emergency department analgesic prescription. Am J Public Health 93:2067–2073PubMedCrossRefGoogle Scholar
  7. 7.
    Martin GS, Mannino DM, Eaton S, Moss M (2003) The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 348:1546–1554PubMedCrossRefGoogle Scholar
  8. 8.
    Angus DC, Wax RS (2001) Epidemiology of sepsis: an update. Crit Care Med 29:S109–116PubMedCrossRefGoogle Scholar
  9. 9.
    Wong MD, Shapiro MF, Boscardin WJ, Ettner SL (2002) Contribution of major diseases to disparities in mortality. N Engl J Med 347:1585–1592PubMedCrossRefGoogle Scholar
  10. 10.
    Arnott ID, Ho GT, Nimmo ER, Satsangi J (2005) Toll-like receptor 4 gene in IBD: further evidence for genetic heterogeneity in Europe. Gut 54:308PubMedGoogle Scholar
  11. 11.
    Clark LT (2005) Issues in minority health: atherosclerosis and coronary heart disease in African Americans. Med Clin North Am 89:977–1001PubMedCrossRefGoogle Scholar
  12. 12.
    Esper AM, Moss M, Lewis CA, Nisbet R, Mannino DM, Martin GS (2006) The role of infection and comorbidity: Factors that influence disparities in sepsis. Crit Care Med 34:2576–2582PubMedCrossRefGoogle Scholar
  13. 13.
    Dombrovskiy VY, Martin AA, Sunderram J, Paz HL (2007) Occurrence and outcomes of sepsis: influence of race. Crit Care Med 35:763–768PubMedCrossRefGoogle Scholar
  14. 14.
    McGee D, Cooper R, Liao Y, Durazo-Arvizu R (1996) Patterns of comorbidity and mortality risk in blacks and whites. Ann Epidemiol 6:381–385PubMedCrossRefGoogle Scholar
  15. 15.
    American College of Physicians (2000) No Health Insurance? It’s Enough to Make You Sick. American Society of Internal Medicine, PhiladelphiaGoogle Scholar
  16. 16.
    Kasper JD, Giovannini TA, Hoffman C (2000) Gaining and losing health insurance: strengthening the evidence for effects on access to care and health outcomes. Med Care Res Rev 57:298–318PubMedCrossRefGoogle Scholar
  17. 17.
    Danis M, Linde-Zwirble WT, Astor A, Lidicker JR, Angus DC (2006) How does lack of insurance affect use of intensive care? A population-based study. Crit Care Med 34:2043–2048PubMedCrossRefGoogle Scholar
  18. 18.
    Barnato AE, Berhane Z, Weissfeld LA, Chang CC, Linde-Zwirble WT, Angus DC (2006) Racial variation in end-of-life intensive care use: a race or hospital effect? Health Serv Res 41: 2219–2237PubMedCrossRefGoogle Scholar
  19. 19.
    Lillie-Blanton M, Maddox TM, Rushing O, Mensah GA (2004) Disparities in cardiac care: rising to the challenge of Healthy People 2010. J Am Coll Cardiol 44:503–508PubMedCrossRefGoogle Scholar
  20. 20.
    Johnston SC, Fung LH, Gillum LA, et al (2001) Utilization of intravenous tissue-type plasminogen activator for ischemic stroke at academic medical centers: the influence of ethnicity. Stroke 32:1061–1068PubMedCrossRefGoogle Scholar
  21. 21.
    Ayanian JZ, Weissman JS, Chasan-Taber S, Epstein AM (1999) Quality of care by race and gender for congestive heart failure and pneumonia. Med Care 37:1260–1269PubMedCrossRefGoogle Scholar
  22. 22.
    Mortensen EM, Cornell J, Whittle J (2004) Racial variations in processes of care for patients with community-acquired pneumonia. BMC Health Serv Res 4:20PubMedCrossRefGoogle Scholar
  23. 23.
    U.S. Department of Health and Human Services (2005) National Healthcare Disparities Report. Available at:; accessed December 2007.Google Scholar
  24. 24.
    Clark LT, Ferdinand KC, Flack JM, et al (2001) Coronary heart disease in African Americans. Heart Dis 3:97–108PubMedCrossRefGoogle Scholar
  25. 25.
    Taylor AL, Ziesche S, Yancy C, et al (2004) Combination of isosorbide dinitrate and hydralazine in blacks with heart failure. N Engl J Med 351:2049–2057PubMedCrossRefGoogle Scholar
  26. 26.
    Mayr FB, Spiel AO, Leitner JM, et al (2007) Duffy antigen modifies the inflammatory response in human endotoxemia. Crit Care Med [Epub ahead of print]Google Scholar
  27. 27.
    Sorensen TI, Nielsen GG, Andersen PK, Teasdale TW (1988) Genetic and environmental influences on premature death in adult adoptees. N Engl J Med 318:727–732PubMedGoogle Scholar
  28. 28.
    Mira JP, Cariou A, Grall F, et al (1999) Association of TNF2, a TNF-alpha promoter polymorphism, with septic shock susceptibility and mortality: a multicenter study. JAMA 282:561–568PubMedCrossRefGoogle Scholar
  29. 29.
    Yim JJ, Ding L, Schaffer AA, Park GY, Shim YS, Holland SM (2004) A microsatellite polymorphism in intron 2 of human Toll-like receptor 2 gene: functional implications and racial differences. FEMS Immunol Med Microbiol 40:163–169PubMedCrossRefGoogle Scholar
  30. 30.
    Nelson S, Kolls JK (2002) Alcohol, host defence and society. Nat Rev Immunol 2:205–209PubMedCrossRefGoogle Scholar
  31. 31.
    Torres A, Serra-Batlles J, Ferrer A, et al (1991) Severe community-acquired pneumonia. Epidemiology and prognostic factors. Am Rev Respir Dis 144:312–318PubMedGoogle Scholar
  32. 32.
    Pierce JP, Fiore MC, Novotny TE, Hatziandreu EJ, Davis RM (1989) Trends in cigarette smoking in the United States. Educational differences are increasing. JAMA 261:56–60PubMedCrossRefGoogle Scholar
  33. 33.
    Mosenifar Z (2007) Population issues in clinical trials. Proc Am Thorac Soc 4:185–187PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media Inc. 2008

Authors and Affiliations

  • F. B. Mayr
    • 1
  • S. Yende
    • 1
  • D. C. Angus
    • 1
  1. 1.CRISMA Department of Critical Care MedicineUniversity of Pittsburgh School of MedicinePittsburghUSA

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