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The Amputation Epidemic in Black America: What Everyone Needs to Know
Peer-reviewed studies have revealed that black patients are three times more likely to lose limbs than the national average. In black populated areas with little or no access to quality healthcare, these rates alarmingly increase to eight times the national average.
Inequality in the National Healthcare System
In the words of Dr. Camara Jones, a physician and epidemiologist, race is not biology. For a long time now, there have been perceptions that there could be biologically-based differences in the races. This is a false narrative with scientists going a step further to prove that all humans largely have the same genetic make-up. Race is not the problem, racism is.
Unequal and inequitable healthcare in America has deep roots linked to slavery, legally sanctioned segregation, and structural racism. A recent study found that factors like healthcare access, household density, and pervasive discrimination are the driving forces for disparities in healthcare.
The Peripheral Artery Disease (PAD) Pandemic
Peripheral artery disease (PAD) – a serious threat for aging adults – is a common cause of lower limb amputation. It involves constricted perfusion in the lower limbs due to clogging of the peripheral arteries. According to the Centre for Disease Control and Prevention (CDC), PAD affects approximately 6.5 million Americans over 40 years. Further, African Americans are twice as likely to develop PAD.
Different studies conducted in 2019 discovered that over 5% of adults aged 25 years and above have PAD. Risk factors for PAD include diabetes, high blood pressure, high cholesterol, and nicotine use. If not noticed early, PAD gets to an advanced stage, which often makes lower limb amputation the only option to manage it.
Another study shows that about 85% of the annual amputations that happen across America are preventable. Early diagnosis is vital for limb salvage. Unfortunately, black communities lack access to diagnostic tests used to identify PAD. Southern states like Mississippi, also called America’s “Diabetes belt” have a low wound care specialist to patient ratio. This impact of systemic racism is also greatly felt in low-income neighborhoods of California occupied by high numbers of minorities.
According to a Health Affairs study, the amputation rates vary ten-fold between low and high socioeconomic status communities. Most hospitals and healthcare centers that black people have access to have neglected amputation prevention. They don’t have capacity for proper wound care, which would otherwise massively boost amputation prevention.
As if to rub salt in the wound, amputations have been linked with higher fatality of patients. The five-year death rates for patients who undergo below-the-knee amputations range from 40 to 82%. Chances are that clogging of the peripheral arteries doesn’t stop even after amputation and continues to be a risk factor for heart attack and stroke.
PAD Awareness
Preventive care needs to be emphasized. The African American Community needs to invest significant time and resources in raising awareness of this pandemic. The real tragedy as previously explained is that most PAD cases are never diagnosed or treated early. If people can understand the risks of PAD, then at-risk individuals can go for early screening as well as learn to look out for telling signs. In most cases, if people monitor their blood circulation and sugar levels, amputations can be avoided. One exemplary doctor pushing for amputation prevention among blacks is Dr. Fakorade, based in Mississippi. More than 80% of patients at his clinic are Black with only 7% possessing commercial insurance. His zeal has helped so many avoid limb loss with only fewer than 10 of his patients suffering major amputations since 2016.
Better Healthcare for Black and African Americans
Beyond poor diet and lack of awareness, the disinvestment in minority communities has greatly fueled the amputation epidemic in Black America. The federal and state governments need to invest in preventive healthcare and make it accessible to black minorities.
In 2019, the Congressional PAD Caucus was formed to create awareness in Congress and communities about PAD, as well as improve research and treatments to reduce the rates of amputations in the U.S. Rep. Donald Payne, Jr. (D-N.J.), chair of this caucus, introduced the bipartisan Amputation Reduction and Compassion (ARC) Act (H.R.2631) with several others in congress. The Act aims at establishing a PAD education program for podiatrists, wound care specialists, vascular surgeons and other healthcare professionals as well as the public, with a special focus on at-risk populations. Further, this policy seeks to tackle unfair disparities that communities of color face when it comes to PAD management.
Leveraging Technology in Wound Care
By bringing together healthcare professionals such as podiatrists, vascular surgeons, and wound care specialists throughout the country, The Wound Docs is helping to reduce the sky-high rates of lower-limb amputations in Black communities. The Wound Docs is leveraging the power of advanced technologies such as artificial intelligence and advanced biologics (skin substitutes) to significantly improve patient outcomes in wound care for African Americans.
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The Amputation Epidemic in Black America: What Everyone Needs to Know
Peer-reviewed studies have revealed that black patients are three times more likely to lose limbs than the national average. In black populated areas with little or no access to quality healthcare...
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