this post was submitted on 13 Feb 2024

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148

A death sentence: Native Americans have least access to liver transplant system (themarkup.org)

submitted 1 year ago by [email protected] to c/[email protected]

9 comments fedilink hide all child comments

Despite being more likely to die of liver disease, Native Americans are far less likely to make the transplant list than White people

Native Americans are far less likely than other racial groups to gain a spot on the national liver transplant list, despite having the highest rate of death from liver disease, according to an analysis of four years of transplant data by The Markup and The Washington Post.

Compared with their total number of deaths from liver disease, White people gain a spot on the transplant list almost three times more often than Native Americans, the data shows. Had transplant rates been equal, nearly 1,000 additional Native people would have received liver transplants between 2018 and 2021.

Native Americans who do win a spot on the list advance to surgery at about the same rate as White people, showing that list access is a primary driver of disparity. Among other racial groups, the liver transplant acceptance rate for Black people is slightly lower than for White patients nationally, while Asian Americans have the highest rate of acceptance to the transplant waitlist by far.

These findings come as mortality from liver disease is climbing across the nation, hitting nearly 57,000 deaths in 2021, according to the Centers for Disease Control and Prevention. Liver disease is commonly caused by obesity, hepatitis C, and alcoholism. Researchers have attributed the rise in mortality to increased heavy drinking during the pandemic, especially among young people.

Data show poor access to inpatient treatment for alcoholism for tribes across the country. The only cure for end-stage liver disease is a transplant. And getting on the list typically involves a referral by a doctor, which can be hard for those with limited resources to access.

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[–] [email protected] 2 points 1 year ago* (last edited 1 year ago) (7 children)

White people fucking over indigenous people?!

That happens?!

[–] Shiggles 19 points 1 year ago (1 children)

I’m failing to see in the article any sort of control for the whole “higher rate of liver failure” - that’s because of alcoholism. It says those accepted advance the same - but nothing about why others are rejected. If they’re rejected because they still don’t have their alcoholism under control, that’s the same treatment any other race would get.

Is it great? Hell no! Have native americans been dealt a shitty hand and is their tendency towards alcoholism due to society failing them? Absolutely. But being denied a liver transplant due to not being expected to take care of a new one is just standard fare. Solve the issues driving them to alcoholism, the liver transplant system is working fine.

[–] [email protected] 6 points 1 year ago (1 children)

How often are white people granted liver transplants for that same higher rate of failure? Are indigenous Americans alcoholics in so much greater numbers than white people that the 1000:1 ratio makes sense? I find that hard to believe.

[–] [email protected] 4 points 1 year ago (1 children)

They make up 1% from google search. It's also area dependent. Are indigenous people spread out evenly? If a state has none of them or extremely low amounts, their rate is reflected.

Your number is extremely flawed. We should see 1% when we see 0.1% of liver transplant being assigned to them assuming there's only one country wide waiting list and they're evenly spread.

[–] [email protected] 4 points 1 year ago (1 children)

It's not my number, it's the number I got from the article.

[–] [email protected] 2 points 1 year ago* (last edited 1 year ago) (1 children)

Can you explain further? I don't see anywhere the article could be interpreted to say 1000:1. It says that 1000 more native people (total) would have been accepted if acceptance rates were equal.

Compared with their total number of deaths from liver disease, White people gain a spot on the transplant list almost three times more often than Native Americans, the data shows. Had transplant rates been equal, nearly 1,000 additional Native people would have received liver transplants between 2018 and 2021.

It drills further into the numbers:

For every 100 Asian people who died from liver disease, approximately 68 patients were accepted for a transplant from 2018 to 2021. Among White people, 26 patients were accepted; among Black people, it was 23. (Latinos, who are assigned to various racial groups in the data, are excluded from this analysis.)

Among Indigenous people, just nine patients were accepted for a transplant in that period for every 100 who died from liver disease.

By that, it looks like the acceptance rate of Caucasians is about 3x that of native Americans, and it looks like Asians are accepted at 2.6x the rate of Caucasians and 7.6x the rate of native American people.

[–] [email protected] 1 points 1 year ago (1 children)

Had transplant rates been equal, nearly 1,000 additional Native people would have received liver transplants between 2018 and 2021.

[–] [email protected] 1 points 1 year ago

Imagine 10,000 white people need livers, and 10,000 first Nations people need livers.

If all 10,000 white people recieved livers, and only 9,000 FN people got livers, that would mean that:

"Had transplant rates been equal, 1,000 additional FN people would have received liver transplants"

You will notice, that in the scenario I described, the ratio would be 9:10, not 1:1000.

In short, you can not derive the ratio given the information you have presented.

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