# Black Bodies Matter: An examination of Diabetes, Peripheral Artery Disease and Limb Amputation Disparities in Black and White participants of the All of Us Research Program.

> **NIH NIH U54** · XAVIER UNIVERSITY OF LOUISIANA · 2022 · $198,914

## Abstract

Project Summary
 Social disadvantage, unequal access to care and systemic racism are identified as primary
culprits leading to poor health outcomes among Black Americans. Further exacerbating the problem are
budget cuts to public health funding for health care and social service programs that serve a large
segment of the Black community. Empirical findings confirm disparities in health care for Black patients
with complicated PAD and lower limb ischemia. The literature well-explains the diabetes disease process
that leads to PAD and identifies those at greatest risk for the devastating outcome, limb amputation.
One of the gaps in the research is the identification of factors leading to the earlier onset of co-occurring
PAD in individuals with diabetes and the identification of contributing factors (on the part of patients
and health care providers) that lead to the decision to amputate a limb more often in Black patients
than other populations. The proposed research addresses these two gaps.
 The proposed research seeks to utilize the case of diabetes with PAD and a limb amputation
epidemic to not only shed new light on a long-established and well-documented problem, but also to
provide evidence in support of adherence to practice guidelines and preventive efforts to improve PAD,
minimize loss of limb, and enhance overall quality of life for Black patients. Inconsistent adherence to
guidelines in clinical practice is, according to the United States Preventive Services Task Force, at the
heart of excessive limb amputation among Blacks with diabetes and concomitant PAD. Generally,
accepted practice and prevention guidelines support the use of simple, diagnostic measures for
screening and monitoring of PAD progression, and yet, documented by our research, the rate of limb
amputation continues to climb, particularly in geographic regions of the United States with large
proportions of Black persons. This is particularly unfortunate because revascularization and other
therapeutic alternatives are available that should be considered before the decision is made to
amputate a limb.
 Using the All of Us (AoU) Data, this study aims to understand cultural, environmental, and
decision-making factors that contribute to disparities in diagnosis and treatment for PAD with diabetes
and subsequent limb loss. Aim 1: Compare the factors influencing early onset (before age 45), co-morbid
peripheral artery disease in Black and White patients with diabetes.
Aim 2: Examine the relationship between the screening practices and limb amputation in patients with
diabetes and concomitant peripheral artery disease. Aim 3: Examine factors influencing practice
decisions to amputate a lower limb in Black and nonblack patients in the United States.

## Key facts

- **NIH application ID:** 10654453
- **Project number:** 3U54MD007595-14S3
- **Recipient organization:** XAVIER UNIVERSITY OF LOUISIANA
- **Principal Investigator:** Gene D'Amour
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $198,914
- **Award type:** 3
- **Project period:** 2009-09-24 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10654453

## Citation

> US National Institutes of Health, RePORTER application 10654453, Black Bodies Matter: An examination of Diabetes, Peripheral Artery Disease and Limb Amputation Disparities in Black and White participants of the All of Us Research Program. (3U54MD007595-14S3). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10654453. Licensed CC0.

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