Health disparities based on race and ethnicity are both widespread and pervasive — and radiology is no exception.
Colwell
To put this into perspective, according to a study published in BMC Health Services Research, the use of imaging varies significantly depending on a patient's race. After reviewing millions of emergency room encounters taking place over the course of 11 years, the study concluded that non-white patients were less likely to receive imaging services.
How less likely? According to the study, white patients received medical imaging 49% of the time. In comparison, non-white patients received imaging just 41% of the time, with black patients being 21% less likely to receive imaging than their white counterparts.
In other words, there is great disparity.
According to Rebecca Colwell, a medical student at the University of Wisconsin School of Medicine and Public Health, this racial disparity is even more concerning due to the gatekeeper role that diagnostic imaging plays in modern medical practice.
"Without proper imaging, many non-white patients are left undiagnosed, which opens the door to further complications and disparities down the road," Colwell said. "For example, not only do minorities often present at later stages of cancer diagnosis, they also suffer from increased mortality from those cancers."
A Roadmap for Addressing Racial Disparity in Radiology
In her digital poster, Colwell summarizes the existing literature on race-based inequities in diagnostic imaging. "Lots of work has been done across a variety of disciplines in medicine, but this work has not been synthesized," she explained. "Our goal was to make a roadmap for future radiology health equity work and, more importantly, make this information easily accessible to researchers."
The hope is that radiologists use this roadmap to better address issues of racial disparity in medicine. "Radiologists can help mitigate disparities they encounter by identifying the causative factors within their health system," Colwell explained. "They can also educate other providers on ordering protocols to maximize appropriate imaging for patients."
Colwell also noted that radiologists are well-positioned to develop strategies for mitigating health disparities through the thoughtful application of radiologic technology. This includes utilizing electronic medical records and demographic data to identify individuals at an increased risk of missing screenings or who have missed follow-up imaging. Targeted outreach can then be offered to avoid these missed opportunities for care.
Collaborating for a More Equitable Health Care System
According to Colwell, the end goal is to ensure that all patients have access to the right diagnostic exam. "Achieving this goal requires us to be open to collaborating with health care teams in other fields and to implementing system changes that will decrease these disparities," she said. "We also need to advocate for positive change within our own spheres of influence."
To help radiology achieve this goal, Colwell is currently studying clinical topics of relevance to under-represented populations, working to link imaging disparities to health outcomes, and exploring strategies to mitigate disparities and promote an equitable health care system.
Visit the Learning Center for the poster presentation, "Racial Inequities in the use of Diagnostic Imaging: A Systematic Review," (NPM03-C1) will take place on Tuesday, Nov. 30, at 4 p.m. Learn more at Meeting.RSNA.org
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