Pittsburgh, Jan. 10 - The death rate for coronary heart disease is 40 percent higher for African-Americans than it is for whites. Understanding such racially based inequalities in health and health care is important in moving toward a healthier America. In line with that focus, the University of Pittsburgh Graduate School of Public Health (GSPH) has received a federal grant of $1.85 million to study differences in health and self-care among chronically ill elderly blacks and whites in western Pennsylvania, and the effects of these differences.
The study will compare long-term changes in self-care behaviors of African-Americans and Caucasians, age 65 and older, who are suffering from at least one of two chronic illnesses that are prevalent among the elderly -- osteoarthritis or ischemic (coronary artery) heart disease. Self-care behaviors are defined in the study as activities that individuals perform in caring for themselves as a result of their illness, such as exercising, modifying their diets and taking medications, home remedies, vitamins or other herbal or nutritional supplements.
"This grant will allow us to look at differences in how elderly black and white patients care for themselves and how these self-care behaviors change over the length of the illness, and to determine if those differences affect health outcomes," said Myrna Silverman, Ph.D., professor of public health and anthropology, and the study's principal investigator.
Researchers will conduct four personal and three telephone interviews with 1,200 patients from Allegheny County (50 percent African American and 50 percent white) over a period of 30 months. Information gathered from the participants will help researchers define how patients develop, maintain and change self-care behaviors, and how these behaviors are affected by changes in the disease, the patient's environment and his or her own social and psychological characteristics. Results will show how these self-care behaviors affect the patient's long-term quality of life and physical and mental health, and how racial differences in self-care contribute to different outcomes.
"We believe the results will highlight some differences in minority self-care and elderly self-care in general, which could provide clues for the development of culturally sensitive patient education programs on the importance of particular self-care behaviors for the management of a specific illness," said Dr. Silverman. "This could lead to an improvement in health services and, ultimately, the health of all older adults."
This research is a follow-up to a previous study in which Dr. Silverman gathered data on self-care behaviors and found significant differences according to race. The current study will focus on the changes in these behaviors over time, and the effects these behaviors have on the patient's health.
The study, which will be completed in mid-2004, is funded through a grant from the National Institute on Aging, one of the National Institutes of Health.
Established in 1948, the GSPH at the University of Pittsburgh is world-renowned for contributions that have influenced public health practices and medical care for millions of people. It is the only fully accredited school of public health in the Commonwealth of Pennsylvania and is one of the top-ranked schools of public health in the United States. It is one of eight schools across the country to be designated a Public Health Training Center by the U.S. Department of Health and Human Services. For more information about the GSPH, access the school's website at http://www.