Brown
AF, Perez-Stable EJ, Whitaker EE, Posner SF, Alexander M, Gathe J, Washington
AE. Ethnic differences in hormone replacement prescribing patterns.
J Gen Intern Med 1999;14(11):663-9.
The goal of this study was to compare hormone replacement (HRT) prescribing
patterns by race and to assess the extent to which age, comorbid illness,
and socioeconomic status affect these patterns. Data were obtained from
a computerized medical record system for outpatient visits to a university
medical center between 1992 and 1995. Records for all women aged 50 and
older seen in specific practice types were included in this study.
White women were more likely than all others to be prescribed estrogen
(33.1% of whites versus 25.1% of African Americans, 23.1% of Latinas,
21.1% of Asians, and 6.6% of Soviet immigrants). These differences remained
after adjusting for age, median income, diabetes, hypertension, CHD, and
osteoporosis.
As an explanation for these patterns, the authors suggest that "ethnic
differences in health status and in the utilization of health care services
in the US are most often ascribed to SES factors, but cultural factors
affecting patient-clinical communication may also play an important role."
Culture and communication issues were raised as potential explanations
for the disparity in HRT use between Soviet immigrants and other white
women; and culture and language factors were cited as potentially influencing
decisions to use HRT among Asian and Latina women.
