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Comment & Response
April 2020

Database Inaccuracies and Disparities in Care Among Homeless Adults Hospitalized for Cardiovascular Conditions—Reply

Author Affiliations
  • 1Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
  • 2Cardiovascular Division, Department of Medicine, Washington University School of Medicine in St Louis, St Louis, Missouri
JAMA Intern Med. 2020;180(4):614-615. doi:10.1001/jamainternmed.2020.0021

In Reply We appreciate Essien and colleagues’ thoughtful commentary on race, housing status, and health outcomes. In our analysis1 of 3 states (Massachusetts, New York, and Florida) from 2010 to 2015, homeless persons hospitalized for cardiovascular conditions were less likely to receive indicated cardiovascular procedures, and had higher mortality rates, than those who were not homeless. Strikingly, 38.6% of these homeless individuals were black. We agree with Essien and colleagues that it is imperative that hospitals provide equitable care regardless of individuals’ housing status or racial identity. More broadly, we believe that policy efforts are urgently needed to tackle the underlying structural determinants of homelessness that disproportionately affect black Americans.

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