The series was reported by Liz Kowalczyk, Todd Wallack, Nicole Dungca, Akilah Johnson, Andrew Ryan, Adrian Walker, and also editor Patricia Wen. Today's story was written by Kowalczyk.

You are watching: Boston hospital care based on race


Patients fly in from everywhere the country to get treatment at Massachusetts basic Hospital. Yet, most black Bostonians don’t take trip the five to 10 miles from their communities to take advantage of the hospital’s immense medical resources. Just 11 percent of Bostonians admitted come the city’s biggest hospital space black, far less 보다 its peers.

The picture is similar at Dana-Farber Cancer Institute, among the world’s peak oncology centers. Virtually 2 in every 5 white Boston citizens diagnosed through cancer are treated there, but, amongst black residents with the disease, the 1 in 5.

Across town, meanwhile, white occupants of the South end are much more likely than black citizens to leave the neighborhood for inpatient care rather 보다 go to surrounding Boston clinical Center, when a public hospital. Blacks account for fifty percent of Boston patient at the previous Boston City Hospital -- by far the most of any kind of hospital in the city.

Though the worry gets scant attention in this center of world-class medicine, distinction patterns room deeply imbedded in Boston health and wellness care. Merely put: If you space black in Boston, girlfriend are less likely come get treatment at numerous of the city’s elite hospitals 보다 if you are white.

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Massachusetts basic Hospital treats a lower percentage of black color patients than many Boston hospitals, but internal surveys post by MGH online show that minorities who execute get treatment there price it highly. (Suzanne Kreiter/Globe Staff)The factors are complex. More whites live near Mass. General. Specific lower-cost wellness insurance plans usually don’t salary for treatment at Harvard clinical School’s high-priced academic medical centers, including Dana-Farber and MGH. And some blacks room uncomfortable at largely white organizations — or those organizations may no make them feel welcome — a divide compounded by a dearth of black color physicians.

All the this creates most likely disadvantages because that blacks, that suffer far worse health overall than whites due to the fact that of poverty and also environmental factors — a void city planners newly said is persistent and also growing. Some black leaders issue that blacks room handicapped due to the fact that they nothing have, or don’t think they have, the same array of health treatment choices.

“People in our very own backyard should have the ability to utilize this resource,’’ stated Dr. Christopher Lathan, one of the few black oncologists at Dana-Farber.

As component of its check of whether Boston deserves its reputation as unwelcoming to blacks, the Spotlight Team probed the pressures driving segregation trends in health care. The team obtained patient discharge and also hospital employment data not generally easily accessible to the public, produced databases, interviewed nationwide researchers, and also spoke to an ext than 50 black color Bostonians about their health care experiences, and the conclusions were inescapable:

Despite a decade of intense and also in some cases successful initiatives by city leaders and high-ranking hospital public official to improve health treatment for minorities, details patterns the segregation remain stubbornly entrenched, threatening to undermine the ar mission that equitable treatment for everyone.

Massachusetts’ first-in-the-nation regulation mandating wellness insurance coverage, designed to increase equity in medical care, shows up to have produced greater — not less — hospital segregation, follow to a scholarly record published last year. The law raised the variety of blacks with wellness insurance, and with that, potential accessibility to a broader array of hospitals.

But castle did not leave the organizations that have historically invited minorities, consisting of Boston medical Center. The concentration of decimal actually enhanced at this institutions, follow to the paper.

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Boston Medical center is the an outcome of a merger with a former public hospital that had actually a long history of dealing with the city’s minorities, a tradition that endures today. (Suzanne Kreiter/Globe Staff)“African-Americans in Boston space loyal to the old Boston City, due to the fact that it was the hospital that offered them as soon as no one rather would,’’ said Dr. Karen Lasser, who works in ~ BMC and was the command author.

occasionally that loyalty is reinforced through experience. A young mommy out because that a walk v her toddler ~ above a September afternoon claimed she was born in ~ BMC and also remained a faithful patient till she moved to Charlestown 2 years ago. Enduring from flu symptom one night, she take it the bus to the the next hospital: Mass. General.

There, the just other black person in the room was an inebriated man, claimed Monique, that did not desire the globe to publish her last name. And she feel white staff treated the white patients an ext warmly 보다 they did her. “I am out of my lull zone,’’ she thought.

Officials at Mass. General, nationally known for its initiatives to alleviate disparities in health care, claimed in a created statement the hospital surveys display black and also Hispanic patients feel they space treated the very same as whites. Provided the country’s history of discrimination, blacks may distrust the health care system and “even a seemingly little and subtle problem can be viewed as unfair and discriminatory,’’ follow to the declare e-mailed through spokeswoman Peggy Slasman.

Indeed, stories of poor treatment while acquiring medical treatment are strikingly common among blacks. Eleven percent of black Bostonians reported gift mistreated by health care professionals because of their gyeongju in the city’s health care survey in 2013, compared to 2.5 percent that white residents. Those numbers have actually barely budged over a decade.

Public health and wellness officials agree that one means to convey this distrust is come hire much more black physicians. However recruiting black medical specialists to the city has proved to be challenging, even at BMC, partly due to the city’s reputation rooted in events such as court-ordered busing in the 1970s.

“Those historic events that have occurred are still lingering in people’s minds,’’ said Dr. Thea James, a black doctor at BMC.

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Shirley Coffey felt she was maintained waiting much longer than white patient in the Brigham and Women’s Hospital emergency room years ago. The hospital said it’s confident patients are treated same today. (Suzanne Kreiter/Globe Staff)

Deciding wherein to go

People often tend to seek regimen medical treatment close to home, for this reason it’s no surprising that Mass. General, close to the largely white and wealthy Beacon Hill neighborhood, has plenty of white patients. It’s additionally a statewide referral center, with 70 percent the its patients coming from areas of Massachusetts external Boston. And also its wellness centers have tendency to be in or close to Hispanic communities.

In the exact same way, it renders sense the Boston clinical Center, near big black populations in Roxbury and Dorchester, would certainly treat many blacks.

But a Globe analysis of hospital discharges by where patients live shows that location alone go not define where they go. Even among residents of the communities that surround Mass. General — the back Bay, Beacon Hill, Charlestown, eastern Boston, the phibìc End, and the West end — whites to be admitted to the hospital at twice the rate of blacks.

Or take it the Fenway. Much more than one-third of patients in that neighborhood who were hospitalized end a five-year duration went to nearby Brigham and also Women’s Hospital or Beth Israel Deaconess clinical Center. Yet when they go to an additional hospital in the city, white skin - man most regularly went come Mass. General, when blacks most often headed because that Boston medical Center.

Similar patterns have the right to be seen through the 2 Boston hospitals own by Steward health and wellness Care: Blacks citywide tend to walk to Carney Hospital in Dorchester, while white skin - man are an ext likely to go to St. Elizabeth’s clinical Center, the company’s flagship teaching hospital in Brighton.

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Massachusetts basic Hospital executives to speak the hospital’s location largely dictates patient demographics. The is surrounded by largely white neighborhoods and has health and wellness centers in neighborhoods where plenty of Hispanics live. (Craig F. Walker/Globe Staff)To uncover these neighborhood patterns, the globe analyzed hospital discharge data by Boston ZIP code, comparing each hospital’s share of white patients and also black patients. The Globe derived data for fiscal year 2011 v 2015 because that nine Boston hospitals native the facility for wellness Information and also Analysis, a state company responsible because that collecting and analyzing Massachusetts health treatment data. One caveat: zip codes nothing match areas exactly.

When looked at citywide, the data present that black color Bostonians are more than 3 times as most likely to get care at Boston Medical center and nearly twice as likely to go to Carney together whites. Around 43 percent of Boston patient at Carney room black.

Boston medical Center, the primary teaching hospital for Boston University institution of Medicine, is considered a an excellent hospital by most measures, but in Boston, because of the competition, it survives in the zero of the Harvard institutions.

Mass. General, meanwhile, is the winter image: whites are four times as most likely to be admitted 보다 blacks, though the hospital points out that it treats a larger variety of Hispanic patients 보다 black patients. Hispanics consist of 16 percent the its outpatient primary treatment visits, because that example, plenty of at its ar health centers in Revere and also Chelsea.

Massachusetts Eye and also Ear, next door come Mass. General, also sees a lower percent of black color patients native Boston — 16 percent in the outpatient clinics — 보다 the city populace overall, follow to data provided by the hospital.

At Dana-Farber, which gives mostly outpatient care, the hospital noted internal analysis to the world that likewise showed disparities. Overall, 83 percent that its patients room white and just 5 percent black. About half Dana-Farber’s 59,900 patients critical year come for second opinions, seek a evaluation of your doctor’s original treatment plan.

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where whites and blacks in Boston go when hospitalized, 2011-2015

click a hospital to view the variety of discharges by race, which normally reflects the gyeongju makeup of patient at the hospital. The lines present where patients space discharged. Thicker present indicate an ext patients discharged to an area.