In Reply We appreciate Essien and colleagues’ thoughtful commentary on race, housing status, and health outcomes. In our analysis¹ of 3 states (Massachusetts, New York, and Florida) from 2010 to 2015, homeless persons hospitalized for cardiovascular conditions were less likely to receive indicated cardiovascular procedures, and had higher mortality rates, than those who were not homeless. Strikingly, 38.6% of these homeless individuals were black. We agree with Essien and colleagues that it is imperative that hospitals provide equitable care regardless of individuals’ housing status or racial identity. More broadly, we believe that policy efforts are urgently needed to tackle the underlying structural determinants of homelessness that disproportionately affect black Americans.

在答复中，我们感谢Essien及其同事对种族，住房状况和健康状况进行的深思熟虑的评论。在我们从2010年至2015年的3个州（马萨诸塞州，纽约和佛罗里达州）中，有¹个州的无家可归者因心血管疾病而住院，与非无家可归者相比，接受指示性心血管手术的可能性较小，死亡率更高。令人惊讶的是，这些无家可归者中有38.6％是黑人。我们同意Essien及其同事的观点，即无论个人的住房状况或种族身份如何，医院都必须提供公平的护理。更广泛地说，我们认为，迫切需要采取政策措施，以解决无家可归现象的结构性决定因素，这些决定因素对黑人美国人的影响尤其严重。