Research from the University of California, Los Angeles (UCLA) suggests that older Black men are more likely to die within 30 days of surgery compared with older Black women, white men and white women.

Older Black men are 50% more likely to die after elective surgery compared with white men, according to the study.

Published in BMJ, the retrospective study examined Medicare data from 2016 to 2018 for nearly 1.9 million Black and white individuals 65 to 99 years old who had undergone one of the following eight common surgeries: abdominal aortic repair, appendectomy, cholecystectomy, colectomy, coronary artery bypass, hip replacement, knee replacement, and lung resection.

Researchers suggested that the greater mortality among older Black men may be due to the high amounts of stress and structural racism they experience throughout their lifetime. For example, Black neighborhoods may lack high-quality health care resources, which can lead to delays in treatment, advancement of a disease or more challenging surgeries.

“While a fair bit is known about such inequities, we find in our analyses that it’s specifically Black men who are dying more, and they are dying more after elective surgeries, not urgent and emergent surgeries,” said lead study author Dan Ly, MD, PhD, MPP, an assistant professor of medicine at the David Geffen School of Medicine at UCLA, in a news release.

Ly added that it’s also possible that Black male patients may not be properly treated for other conditions, such as hypertension and diabetes, prior to elective surgery, increasing the risk for poorer outcomes.

Even after accounting for differences between patients, researchers found that Black men had a higher adjusted mortality rate overall. Black men had a mortality rate of about 3.05% compared with 2.69% for white men. Black men who underwent elective surgeries had a death rate of 1.30% compared with 0.85% for white men.

“These differences in neighborhood and home environments and in resources could make it more challenging for Black patients to recover at home and to attend postoperative clinical visits,” researchers wrote. “Our finding that surgical mortality is higher among Black men compared with other subgroups of race and sex is consistent with the finding that Black men have substantially shorter life expectancy at birth compared with other subgroups.”