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Disturbing news about disparities

Posted on January 16, 2008January 17, 2008 by Staff

Chris Fitzsimon

It is no secret that there are vast disparities between the races on a wide variety of health indicators. The latest Report Card on Racial and Ethnic Health Disparities from the Office of Minority Health makes it clear that those disparities aren’t going away any time soon.

Infant mortality rates are higher among African-Americans than whites, as are incidences of heart disease, prostate cancer, breast cancer, high blood pressure, the rate of HIV/AIDS infection and other health indicators.

The report also includes numbers that explain some of the disparities. The poverty rate of African-American families in North Carolina is three times higher than white families and a higher percentage of African-Americans are uninsured.

Economics clearly plays a role in the health differences between the races, but it doesn’t explain everything. A series of reports in medical journals and academic publications suggest that while poverty and access to basic care have an impact, the problem is more complicated and troubling than that.

Last week a study by the Yale School of Medicine found that African-Americans older than 65 with cancer were not as likely to receive the recommended treatment for their disease, with the largest differences in treatment for patients with lung, colon and rectal cancers.

The chief medical officer with the American Cancer Society said that institutional racism is to blame for much of the difference in treatment.

Newsday reported last week on data that shows that poor and minority students are diagnosed with autism much less frequently than non-minority students, prompting concern that some minority children were misdiagnosed with other disabilities.

Some officials blamed lack of access to specialists; others, the distrust of parents of education and medical institutions.

The studies reinforce what has been widely discussed in medical circles for year: that race itself may play a role in treatment and diagnosis of illnesses in minority patients.

A 2002 Institute of Medicine report found “racial or ethnic differences in the quality of health care that are not due to access-related factors or clinical needs, preferences, and appropriateness of intervention.”

It is not only a reminder that those who claim that racism is largely absent from our current society are mistaken. It is an issue that the medical community must tackle aggressively.

There is plenty that policymakers can do as well. While racism does appear to be a factor in health care and health disparities, virtually every study mentions that poverty and access to doctors still contribute to the disparities.

That ought to mean that North Carolina lawmakers should invest more resources in education, preventive care and public-health initiatives that have proven to work for all races, like a clean needle-exchange program to reduce the spread of HIV/AIDS and requiring insurance companies to cover substance abuse treatment as many states do.

They could take a cue from the latest report card from the American Lung Association that gave North Carolina low marks for its anti-smoking initiatives because of the state’s low tobacco tax and the failure to enact a ban on smoking in public places.

Most importantly, the role that poverty plays in a person’s health is yet another reason to invest in programs to help families lift themselves out of it. Affordable housing, ending the waiting list for the child-care subsidy and increasing access to care for the uninsured would be good places to start.

Hard to think of something more important for state policymakers than the health of the people they represent. Sounds like a good topic for all those people who want to be governor to talk about.

Chris Fitzsimon is the director of N.C. Policy Watch.

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