When the researchers did not account for differences in health and social factors, black patients were more likely than white patients to die, be rehospitalized, and have chest pain and worse quality of life after a heart attack. However, when the researchers accounted for health and social factors, the differences between black and white patients were no longer present. Differences in treatments received did not explain the differences after health and social factors were taken into account. In other words, black and white patients who had similar severity of heart and other diseases and similar social factors, such as level of education, had similar heart attack outcomes. Black patients seem to have worse risk factors, such as being poorer; having less insurance or education; and having a higher incidence of diabetes, high blood pressure, and high cholesterol, and this may explain most of the differences in heart attack outcomes.