The State of Black Health
A Dual and Unequal System
May 18, 2009 Dolores Bundy
"Of all the forms of inequality, injustice in health is the most shocking and the most inhuman" -Rev. Martin Luther King
In a racist society, the affect of injustice is all-encompassing. Race not only affects socioeconomic status, biology and the physical environment; it also affects the way health care institutions function to provide services. The reality is that for poor African- Americans and other minorities, health status and outcomes are not aberrations, they are pervasive and system-wide. Along with the poor performance of the health system, poor nutrition, toxin-exposed environments, insufficient housing, poor health habits and health-risky behaviors also create a detrimental state for the disadvantaged.
John W. Ross, M.D., founder of the Atlanta Multi-Specialty Group that houses more than 20 physicians, six locations and fifty affiliates, believes that healthcare is not the problem. “The health care issue is one of delivery,” Ross contended. “It’s how the healthcare system gets to minorities. It’s a two-fold problem. You have to take care of yourself in order to get good health care. It’s a combination of the foods you eat; that’s a cost issue - an issue of dollars and cents.”
People in Higher Income Brackets Afford Better Care
“The disparity is in the economics between minorities and other groups who are not disadvantaged,” Ross said. “To improve the health of African-Americans and other minorities, health care institutions must be more than affordable, they must be just!”
To improve the health of African Americans, it is not sufficient merely to remove economic barriers to access, believes Lynn-Perry Bottinger, M.D. FACC and clinical interventional cardiologist. Bottinger agrees that while given the disparate rate for African-Americans and Caucasians with many diseases, to know your numbers is what’s important: your blood pressure, your cholesterol profile and BMI [body mass index].
What the Former U.S. Surgeon General has to say
David Satcher, M.D., PhD., director of the National Center for Primary Care at Morehouse School of Medicine and former U.S. Surgeon General, is eminently known for his strong initiative to eliminate racial and ethnic disparities in this country and to improve the state of black health care.
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“The bottom, line is that if we had illuminated disparities in health in the last century, then in the year 2000 there would have been 5000 fewer black babies dying in the first year of life in this country,” Satcher said. “There would have been more than 25,000 fewer black people dying of heart disease. And had we eliminated disparity then, there would have been 85,000 fewer black deaths in this country. This is not just a matter of disparity. It’s not that abstract. It’s about life and death and unnecessary pain and suffering!”
The disparity in the African-American paradigm
African-Americans have always been aware of the U.S. health system’s race and class problem through their traditional interface with the system. And African-Americans have survived the worst health status, suffered the worst health outcomes and been forced to utilize the worst health services of any other racial or ethnic group in the U.S. for nearly four centuries.
Louis W. Sullivan, M.D. President Emeritus of Morehouse School of Medicine and recipient of 51 honorary degrees, is highly regarded for his contribution to improving the state of black health in America.
“The bottom line is that the health status of African-Americans is not as good as whites,” Sullivan said. "The numbers are staggering. The life expectancy is six to eight years shorter. Death rates from heart disease, stroke, cancer, etc. are one and a half to two times higher, and infant mortality is twice as high among African Americans. Those and a number of other parameters indicate that we have a lot to do to close the health status gap.”
Read more at Suite101: The State of Black Health: A Dual and Unequal System
http://medicalethics.suite101.com/article.cfm/the_state_of_black_health#ixzz0bNv3K17H