J Natl Med Assoc. 2011 Jun;103(6):492-7.
Peiris AN, Bailey BA, Peiris P, Copeland RJ, Manning T.
Department of Internal Medicine, East Tennessee State University, Johnson City, USA. alan.peiris at va.gov
African Americans have lower vitamin D levels and reduced health outcomes compared to white Americans. Vitamin D deficiency may contribute to adverse health outcomes in African Americans.
We hypothesized that race would be associated with vitamin D status and testing in African Americans veterans, and that vitamin D status is a major contributor to health care costs in African American veterans compared to white veterans.
A retrospective analysis of the medical data in the Veterans Integrated Service Network 9 (southeastern United States) was performed, and 14148 male veterans were identified. Race was designated by the patient and its relationship to vitamin D levels/status and costs was assessed.
Vitamin D levels were significantly lower and the percent of patients with vitamin D deficiency was significantly higher in African American veterans.
This difference was independent of latitude and seasonality.
Vitamin D testing was done significantly more in white veterans compared to African American veterans (5.4% vs 3.8%).
While follow-up testing was 42% more likely if a patient was found to be vitamin D deficient, white veterans were 34% more likely than African American veterans to have at least 1 follow-up 25-hydroxyvitamin D performed.
African American veterans had significantly higher health care costs, which were linked to lower vitamin D levels; however, the cost differential persisted even after adjusting for vitamin D status. Vitamin D deficiency is highly prevalent in African American veterans and needs improved management within the Veteran Administration system. Vitamin D status appears not to be the sole contributor to increased health care costs in African American veterans.
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