A study at Northwestern's Feinberg School of Medicine, Chicago, Illinois, found that black people in the Windy City are five times more likely than suburban white people to have a limb amputated, researchers said. "Many amputations are preventable," Joe Feinglass, a professor of medicine at Northwestern University, told Reuters. "This means the primary care for minority people may not be very good." The report, published in the May issue of the Journal of Vascular Surgery, said the high amputation rate among black people in Chicago likely reflects racial disparities in healthcare. "Amputation rates give you a basic idea of how the system is performing," Feinglass said. Looking at hospital discharge data from the state health department, the study found that residents of predominantly black ZIP codes in the Chicago area are five times more likely than those in white areas to have a foot or leg amputated. An earlier study found that black Americans are less likely to be treated with potentially limb-saving surgeries before amputation. The reasons for this disparity are complex, Feinglass said. For one, black people suffer disproportionately from diabetes and other conditions that lead to peripheral arterial disease, such as hypertension. They are also more likely than white people and those of Hispanic descent to smoke, which can lead to poor circulation. Black Americans with diabetes are also less likely to have the resources and the know-how to stick to the strict regimen of foot care, medication, and blood-sugar monitoring needed to keep their illness in check. But the larger issue is that low-income minorities get high-quality medical treatment less often than low-income white people. Instead, many go to "providers and hospitals that tend to take care of uninsured and predominantly Medicaid populations," said Romana Hasnaian-Wynia, head of Northwestern's Center for Health Equity. The overall U.S. trend shows a decline in amputations since 2000, said Feinglass, who examined public health records over two decades for eight counties encompassing eight million people in Chicago and its suburbs. In largely black residential areas on Chicago's South and West Sides, the rate of amputations increased to 63 amputations per 100,000 people in 2004 from 60 per 100,000 in 1987. In the largely white areas outside the city, the amputation rate dropped to 12 per 100,000 people in 2004 versus 14 per 100,000 in 1987. In mixed-race areas of Chicago and its inner suburbs, amputation rates held fairly steady at 20 per 100,000 people.
