Geographic Variations in Racial Disparities for Peripheral Artery Disease Treatment in the U.S.

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By Joseph Kim on

Key Takeaways:

  1. Black patients with peripheral artery disease (PAD) had significantly higher major amputation rates than White patients across all U.S. states (3.0% vs. 0.9%, p<0.001), with disparities varying widely by state and correlating strongly with the Social Vulnerability Index (rho 0.46, p<0.001).
  2. Geographic and community-level factors, including socioeconomic vulnerabilities, play a critical role in driving racial disparities in PAD treatment, emphasizing the need for equitable healthcare access and interventions targeting high-risk communities.

Racial disparities in peripheral artery disease (PAD) treatment disproportionately affect Black patients in the United States, particularly in rates of major amputations and revascularization. A comprehensive study of 2,376,300 Medicare Fee-For-Service beneficiaries between 2018 and 2022 revealed significant geographic variation in these treatment disparities between Black and White patients across U.S. states.

Black patients were younger (75.8±7.9 years vs. 76.9±7.8 years, p<0.001) and more likely to be women (54.7% vs. 47.8%, p<0.001) compared to White patients. While Black patients underwent more procedures for PAD overall, including major amputations (3.0% vs. 0.9%, p<0.001) and revascularizations (8.4% vs. 7.0%, p<0.001), their rates of major amputation were significantly higher in all states (p<0.001 for all). These disparities varied widely across states, with certain states exhibiting particularly high rates of amputation in Black patients. For example, disparities were most pronounced in states in the southeastern U.S., correlating with higher social vulnerability index (SVI) scores.

The study found a stronger correlation between amputation rates and the county-level SVI (rho 0.46, p<0.001) compared to revascularization rates (rho 0.10, p<0.001). This suggests that community-level factors, including socioeconomic and healthcare access disparities, may influence treatment patterns for PAD.

The findings of this analysis underscore the need for targeted interventions to reduce disparities and improve outcomes for Black patients with PAD.