People of color are more likely to undergo amputation and, many times, it is unnecessary
While a comprehensive approach is necessary, the best place to start is a focus on people of color and those in medically underserved, rural areas of the United States.
Lawrence Burns
August 12, 2024
You probably know that being Black or Brown in America comes with additional health risks. The enduring harms of racial inequality mean that people of color have higher rates of heart disease, diabetes, and premature death than their white counterparts.
But you may not know that people of color are also more likely to have a foot or leg amputated.
Black Americans are at greater risk of developing peripheral artery disease (PAD), in which fatty deposits build up in the artery walls of the legs, reducing blood flow to the legs and feet. Untreated, this can lead to critical limb ischemia, causing wounds that don’t heal, gangrene, and – in the worst cases – amputation.
Additionally, people of color and those living in medically underserved communities are less likely to receive the care they need to prevent those amputations. According to the Mayo Clinic, Black Americans, Latinos and Native Americans often have PAD diagnosed later, when the disease has become more severe. These groups are also less likely to be offered procedures that can save a limb damaged by PAD.
The good news is that there are treatments to avoid amputation
Of the 10 million Americans who have PAD, some 200,000 undergo amputations every year, and most of those are people of color. Black Medicare recipients are nearly three times more likely to suffer amputation than their non-Black counterparts.
But here’s the good news: Increased access to early detection and preventative testing can prevent 85% of the aforementioned amputations.
The federal Amputation Reduction and Compassion (ARC) Act, introduced by the late Rep. Donald M. Payne Jr., D-New Jersey,, would reduce amputations by requiring Medicare, Medicaid and group health insurance plans to cover preventive screening for high-risk patients. Additionally, the bill would disallow payments for non-traumatic amputations if anatomical testing is not performed first. This would prevent the use of amputation as a first-line treatment for PAD. The bill would also establish a PAD education program at the Department of Health and Human Services, so that doctors are more aware of PAD symptoms.
By focusing on what we know about PAD, and the communities most at risk, we can be well on the way to stopping unnecessary amputations. We need the support of lawmakers and government healthcare policies that encourage prevention and proper treatment. Fortunately, we have the commitment of the bipartisan Congressional PAD caucus– lawmakers who want to see amputations become an absolute last resort.
Smoking and diabetes are among the risk factors for potential amputation
Today, too many people are forced to undergo amputation because it’s the only lifesaving option available to them. As an example, a 20-year-old man with diabetes suffered from reoccurring ulcers. He did not receive timely treatment for his diabetes and, as a result, required a partial foot amputation. Proper medical care can provide intervention opportunities in cases like this one, before amputation is the only option.
Primary care physicians must engage patients with preventative measures and educate them about reducing risk factors. The risk factors for PAD are well established: Those most at-risk are people who smoke, are over the age of 65, or have a history of high blood pressure, diabetes, or high cholesterol.
While a comprehensive approach is necessary, the best place to start is a focus on people of color and those in medically underserved, rural areas of the United States. An integrated, multifaceted approach will be the most effective tool for saving limbs and lives.