UNSPLASH
Māori and Pasifika patients are lagging behind in detecting cardiovascular disease, a new study finds.
New research from the University of Otago shows that heart measurement methods to capture cardiovascular disease are flawed and systematically racist.
The doctors at Aotearoa use body surface area (BSA) calculations based on research from the United States focused on white men to measure heart size to accommodate and treat cardiovascular diseases that fall outside the normal range.
However, a new study of the heart sizes of 263 healthy Pākehā, Māori and Pasikifa men and women has uncovered the ethnic bias of the status quo method.
Co-author of the study, Professor Gillian Whalley, said the BSA method assumes that all bodies have the same composition, disregarding the differences in body composition between different ethnicities.
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†[BSA] works if what’s in the skin is the same, but what’s in the skin isn’t the same because Māori and Pasifika have much higher muscle mass.”
The research shows that Māori and Pasifika have on average larger hearts than their Pākehā counterparts when this factor is taken into account, but when using the BSA method, only body surface area is recognized.
Delivered
Professor Gillian Whalley says Māori and Pasifika have on average larger hearts than Pākehā, but the BSA method used does not recognize that, leaving Māori and Pasifika at greater risk of heart disease.
This means the heart size results have been reversed, leaving Māori and Pasifika behind in the early detection of an abnormal heart size, Whalley said.
“I find it super scary to be honest.”
Cardiovascular disease is one of the leading causes of death in Aotearoa, with Māori twice as likely to die than non-Māori, and 1.5 times more likely to be hospitalized, according to statistics from the Ministry of Health†
Whalley said there’s a story that has tried to explain this death rate that has argued that Māori and Pasifika were late for their heart surgery, that they don’t see their doctor on time, or they don’t take their medications.
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Māori are twice as likely to die of cardiovascular disease than non-Māori.
It’s accepted in the industry, she said, but if the tools and guidelines doctors have used to identify abnormal hearts are based on European measurements, it poses a new barrier to appropriate healthcare.
“It’s not a delayed presentation on behalf of the patient, it’s a failure of the health professional to respond appropriately. The system is stacked against Māori and Pacific patients. It’s systemic racism.
“Even if you go through all the barriers — and there are a lot of barriers, geographic, socioeconomic, health care delivery — and you get to the point where you have an ultrasound of your heart, the stenographer doing the scan and the doctor reporting that it’s white Using European values, you may be contributing to the delay.
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However, she says it’s not individual health care providers that are causing the problem, it’s the source of the research that typically doesn’t account for ethnic differences that drive systemic health care inequalities across the board.
“We are too dependent on research and health guidelines from the United States.
“They’ve been color blind or race blind for so long, like it’s a body with a different skin color, but inside it’s all the same.
“That’s just dangerous. The body is not the same inside, we now know that. I hope the Cardiac Society of Australia New Zealand will issue a new guideline.”
By using ethnically specific research that focused on Aotearoa rather than white America, Whalley hoped the Māori and Pasifika death rates would begin to decline.