"Risk Factors for Peripheral Artery Disease-Related Amputations Among B" by Darnell L. Blake

Date of Conferral

2-1-2025

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Hebatullah Tawfik

Abstract

Evidence suggests that Black Americans (BAs) are at a significantly higher risk of peripheral artery disease (PAD)-related amputations. This study aimed to examine risk factors for non-traumatic lower extremity amputation (NTLEA) among BAs with PAD addressing a significant knowledge gap regarding racial disparities in PAD outcomes. Grounded in Bandura's social cognitive theory, which posits the interplay among personal factors, environmental influences, and behavior, this study examines how age, gender, income, and comorbidities like cardiovascular disease, kidney disease, and diabetes influence NTLEA across various insurance types (private, Medicaid, Medicare, self-pay). This quantitative cross-sectional study used the 2020 National Inpatient Sample, 1% of which were BAs with PAD (n = 9,731). Of these, 2,140 underwent NTLEA. Logistic regression showed significant disparities. Women were less likely to experience NTLEA than men (OR = 0.60, 95% CI: 0.54-0.66, p < 0.001). Kidney disease (OR = 1.19, 95% CI: 1.08–1.32, p = 0.001) and diabetes mellitus (OR = 6.73, 95% CI: 1.21–37.52, p = 0.030) increased the risk of NTLEA while age had no significant effect on NTLEA. Health insurance type modified the associations: private insurance increased NTLEA odds among those with kidney disease (OR = 2.39, 95% CI: 1.2–4.77, p = 0.014), while Medicare decreased it for those with cardiovascular conditions (OR = 0.67, 95% CI: 0.51-0.88, p = 0.004). These findings highlight the urgent need to reevaluate healthcare policies and interventions to mitigate disparities. Findings can be used to create tailored healthcare solutions based on insurance type and comorbidity profiles to foster positive social change and promote equitable health outcomes for BAs with PAD.

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