Reducing Health Disparities: Black Americans and PAD

Peripheral arterial disease (PAD) is more common in Black Americans than any other racial or ethnic group.⁶³ Black Americans are also twice as likely to get an amputation than White Americans due to PAD.⁴⁷

Why do these health disparities exist? And what can be done to reduce the possibility of amputations for Black Americans who have PAD?   

Black Americans at Higher Risk for PAD

The risk of PAD varies between races, sexes, ages, smokers and people with diabetes. The risk of PAD is about 30% for Black men and 28% for Black women, according to a recent study. In comparison, White Americans and Hispanics have a 20% chance to develop PAD.⁶³

The higher risk for PAD may be due to the prevalence of a number of conditions. For example, Black Americans are more likely to have anemia, high blood pressure and diabetes than White Americans.⁴⁷ Diabetes is especially a problem for Black Americans due to biological risk factors including a combination of body mass index, waist measurement, fasting glucose levels, lipids, blood pressure and lung function, says the National Institutes of Health.

Let’s Not Accept PAD-related Amputations as Inevitable

Unfortunately, amputations as a treatment for PAD have been too normalized within the Black American community:

• Black Americans are approximately twice as like to be amputated as White Americans⁴⁷
• Black Americans have a far greater number of annual amputations⁴⁸

This data suggests that Black Americans have less access to care, are admitted to the hospital when sicker and are more likely to be treated at an Emergency Department.⁴⁷ Additionally, many patients and family members accept amputation as a treatment option from doctors who may not be PAD specialists and/or do not have limb salvage programs.

Amputation should be a last treatment option after exploring other minimally invasive approaches and arterial bypass surgery. Early diagnosis is also important so that PAD can be treated before it even becomes limb and life-threatening. Most physicians will diagnose PAD with a simple non-invasive  ankle-brachial index (ABI). This screening test is one of the best ways to determine if a person has PAD and its level of severity.²³ Not surprisingly due to the higher risk of PAD, African Americans are two times more likely to screen positive for PAD than non-Hispanic whites based on data from the American Heart Association.

Because so many PAD and diabetes-related amputations are believed to be preventable, the American Diabetes Association is working to address this disparity in care and has included The Right to Avoid Preventable Amputations in their Health Equity Bill of Rights campaign that launched in 2020.

For More Information

It’s important for patients and loved ones to question if there are alternatives to amputation. Do your research! Don’t put your mobility and potentially your life at risk. Get a second opinion from a PAD specialist before agreeing to an amputation.

Learn about the treatment options available by using CSI’s Find a Doctor tool. Let’s all work together to reduce the PAD health disparities for Black Americans and the number of unnecessary amputations.