While this can arguably be blamed on higher incidences of complications from diabetes and vascular issues, there is not a corresponding ratio of disease prevalence says a new study based in Illinois. Health insurance policies, medical care centers, and local medical staff should be carefully scrutinized.

The overall amputation rate in northern Illinois is declining due to improved care for diabetes and peripheral vascular disease, new research shows.

But not everyone is reaping the benefits.

A new study from Northwestern University’s Feinberg School of Medicine has found people in African American communities on Chicago’s South and West Side have a five times higher rate of lower limb amputations than people in the predominantly white suburbs and exurbs.

“Amputations are the canary in the coal mine for quality of care,” said Joe Feinglass, lead author and research professor of medicine at the Feinberg School. “Many amputations are preventable. This means the primary care for minority people may not be very good. ”

Feinglass said the high rate of amputations means people are not being closely monitored. “They come in with gangrene or a skin ulcer that comes to the attention of a doctor really late and nothing can be done,” he said. “They have to take their leg off.”