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OF EDITORIALS
January 6, 2005
An unhealthy gap
How to provide universal health care in America
is a daunting problem. Studies have indicated that African Americans
have not been well served by the nation’s health system.
However, even those who expected the worst were shocked by an
article published in the December issue of the American Journal
of Public Health.
According to the article almost one million blacks died during
the 1990s because of unequal health care treatment. Researchers
found that 886,202 deaths could have been avoided during that
decade if blacks had received the same medical care as whites.
That is indeed a shocking statistic since the total black population
in the United States according to the 2000 Census was 34,658,190.
It has been known for some time that there are substantial racial
disparities in health care. Black and Latino preschoolers suffering
from asthma are prescribed medication to prevent future episodes
at rates far less than for whites. Bypass surgery is provided
to blacks at rates less than for whites with similar conditions.
Women from racial minorities wait more than twice as long as whites
for follow-up testing after abnormal mammograms.
The argument has been made that these disparities are the result
of economic differences. However, a 2002 report from the Institute
of Medicine concluded that these disparities exist even among
patients with similar levels of education and health insurance
coverage.
It would be simplistic to conclude that this problem is the result
of institutional racism. For example, doctors have just recently
discovered that prostate cancer tends to inflict African Americans
a decade earlier than whites. Consequently, the tests to discover
the condition must now be administered to blacks at a much younger
age.
Another factor is that many African Americans have historically
been denied medical treatment. Consequently, the friendly, accessible
relationship with doctors, which is common for many whites, is
uncustomary for many blacks.
Needless to say, poverty is also a factor responsible for disparate
medical care for racial minorities. The Cambridge Health Alliance
and the Boston Medical Center receive special funds for caring
for the poor and uninsured. The BMC has the capacity to provide
foreign-born patients with assistance in their own language. The
BMC motto “exceptional care without exception” defines
the commitment to equal treatment for all.
The high cost of medical care has increased the Medicaid budget
at both the state and federal levels. There is pressure to cut
back. Those in power hope that the poor will not mobilize to object.
Fortunately, Senator Dianne Wilkerson worked aggressively for
several years to bring the issue of disparate health care for
minorities to the attention of the state Legislature. She was
successful in obtaining some funding and she now serves as co-chair
of the Commission to Eliminate Health and Health Care Disparities
Among Ethnic and Racial Minorities.
Lula Christopher, president of Boston Black Women’s Health
Institute, states the issue succinctly. “It is imperative
that we address the issue of race and its relationship to health
disparities in this country but we must begin to demand as a human
right that each person regardless of age, gender, race and socioeconomic
status is afforded the same access to information, treatment and
research.”
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