Sumner Session: Equity Gaps in Venous Disease and VTE Care

Racial and Gender Disparities in Diagnosis

A review of 542 patients imaged for venous disease found 43 iliocaval obstructions caused by occult pelvic masses, most often uterine fibroids, with Black and Hispanic patients accounting for a disproportionate share of compressive masses and white patients more likely to be treated for an identified mass.

Skin Tone and Delayed Diagnosis

A review of dermatology literature found textbooks depict only 4 to 18 percent of images in darker skin, contributing to venous eczema being misdiagnosed as cellulitis, with Black patients presenting later and with more advanced chronic venous insufficiency than white patients.

Geographic and Socioeconomic Access

Registry data showed higher Neighborhood Deprivation Index scores correlated with more advanced CEAP class at presentation, and a four center study found Black patients had a 12 percent higher risk of advanced presentation, while rural patients often cannot reach tertiary centers for care.

Racial Disparities in VTE

Lifetime venous thromboembolism risk runs near 8 percent in white adults but 11 percent in Black adults, and a hospital wide prophylaxis program using automatic anticoagulation and mechanical devices for every patient cut one system’s VTE rate without increasing bleeding.