Disparities in African Americans

The following differences in socioeconomic status and barriers to healthcare access exist for African Americans with myeloma: 

• issues of financial toxicity⁴ 
• less access to full testing⁵ 
• less access to novel treatments⁶ 
• fewer enrollments in "pivotal" clinical trials that led to FDA drug approvals⁷ 
• less access to CAR T-cell therapy⁸ 
• systemic racism
• lack of trust of the healthcare system

African Americans with myeloma face these disparities in care as well:⁹ 

• fewer transplants 
• more blood product transfusions 
• fewer palliative care consultations  
• less inpatient chemotherapy 
• more use of intensive care 

African Americans, as well as those of other races/ethnicities, would likely benefit from “having a shared racial ethnic background between provider and patient.”² 

New research known as a “Survey on Racism, Discrimination, and Health: Experiences and Impacts Across Racial and Ethnic Groups” conducted by the Kaiser Family Foundation revealed that Black, Hispanic, American Indian Alaskan Native (AIAN,) and Asian adults experience higher levels of unfair treatment during health care visits compared to white adults, with Black women reporting even higher incidences. 

These incidents bring about the possibility of receiving insults, where racial groups feel compelled to be mindful of their appearance to get fair treatment during their health care visits

This “large, nationally representative survey finds that among those who used health care in the past three years, six-in-10 (60%) Black adults, about half of American Indian and Alaska Native (52%) and Hispanic (51%) adults, and four-in-10 (42%) Asian adults say they prepare for possible insults from providers or staff and/or feel they must be very careful about their appearance to be treated fairly during health care visits at least some of the time as compared to one-in-three (33%) White adults who have the same observation.

Additionally, the survey “finds that Black, Hispanic, and Asian adults who have more health care visits with providers who share their racial and ethnic background report more frequent positive and respectful interactions.”²

African Americans may face delayed diagnosis from the time of onset of myeloma symptoms. 

Furthermore, IMF Chief Medical Officer Joseph Mikhael, MD, sheds light on disparities in multiple myeloma care for African Americans in his presentation at the M-Power Project New York City Webinar¹⁰.

In this webinar, Dr. Mikhael said that the average myeloma patient sees their primary doctor three times with symptoms and signs consistent with multiple myeloma. Yet, he pointed out, that the delay from symptom onset to diagnosis is even longer in African Americans, for many reasons including the following: 

• Confounding disease (like diabetes)  
• Access to adequate diagnostics and care  
• Awareness in primary care providers  
• Timely referral to specialists  

Dr. Mikhael, who is active with the IMF’s M-Power Project, set a call to action to educate healthcare providers, health institutions, and patients to be aware of the disease symptoms to be able to capture diagnoses more quickly. 

Additionally, Dr. Mikhael was part of the team that has conducted the following December 2023 retrospective study: “Addressing the disparities: the approach to the African American patient with multiple myeloma.”¹¹ We encourage you to review this study to learn about both biologic and non-biologic disparities unique to African Americans as well as to learn about ways to address these barriers to care.  

Even though there is no definitive evidence to explain why myeloma has a higher incidence among African Americans, some studies have revealed a few factors contributing this.

Explore the IMF's M-Power Project. Partnered with cities across the U.S., this project aims to eliminate health disparities and create better and more equitable access to healthcare for all.