Racial segregation and differential outcomes in hospital care

Sean P. Clarke, Bertha L. Davis, Regina E. Nailon

Research output: Contribution to journalArticlepeer-review


This exploratory study of patients in Pennsylvania (PA) and Virginia (VA) hospitals in 1998-1999 measures the segregation of care for Black patients receiving inpatient care for specific medical and surgical conditions. It also examined inpatient mortality risk for Black patients and the impact of treatment in heavily segregated hospitals on mortality for Blacks and non-Blacks. Segregation of hospital care was found across both states but was more pronounced in PA. Blacks did not experience higher mortality rates than non-Blacks either before or after controls for clinical risk factors in either state and for certain admission types had lower mortality. Both Black and non-Black surgical, heart failure, and lung disease patients treated in VA hospitals with more Black patients had poorer outcomes. Future research should examine how access, patient choice, hospital organization, processes of care, and factors related to nursing care might influence hospital outcomes for patients from different racial backgrounds.

Original languageEnglish (US)
Pages (from-to)739-757
Number of pages19
JournalWestern Journal of Nursing Research
Issue number6
StatePublished - Oct 2007


  • Health services research
  • Hospital mortality
  • Outcomes research
  • Pennsylvania
  • Racial disparities
  • Racial segregation
  • Virginia

ASJC Scopus subject areas

  • General Nursing


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