UMBC institute opens in search of knowledge on minority health Goal is to eliminate gap with the majority

January 13, 1998|By Melody Simmons | Melody Simmons,SUN STAFF

In an effort to learn how and why violence, cancer, asthma and other problems affect the state's minorities, the University of Maryland, Baltimore County yesterday opened an institute dedicated to studying minority health issues.

"Everyone knows there is a major gap between the minority population and the majority population in terms of status of health," said UMBC President Freeman A. Hrabowski III, at the opening of the Institute for Racial and Ethnic Health Studies. "Minority children are less healthy, and many die as infants. The critical question is what do we need to do to eliminate the gap? This is where research is needed."

To understand the institute's mission, several speakers said, look no further than last week's designation of Baltimore as the nation's top city in reported cases of syphilis.

While city health officials say the syphilis outbreak is linked to drug use, UMBC experts and other researchers at yesterday's daylong conference on minority health said syphilis is symptomatic of fundamental health care problems in the inner city.

"It goes to show that for syphilis to re-emerge in America, in Maryland, in Baltimore at the turn of the century is a clear indication that we have a problem with how we approach health care," said Julia B. Anderson, institute director.

Baltimore's soaring syphilis rate -- which has increased by more than three times in reported cases since 1990 -- was noted as a prime example of such health problems.

"It is ridiculous, yet it is happening in this city," said Bill Jenkins, an epidemiologist for the Centers for Disease Control and Prevention. "Why? We know very little about the issues of solving the problem. We have got to start understanding the issues."

Such health concerns will make up the agenda for the institute, part of the university's Center for Health Program Development and Management, which will operate under a $600,000 budget funded through UMBC and the Maryland Department of Health and Mental Hygiene.

UMBC is pursuing $5 million in research grants for the institute, Anderson said, and officials expect to use their data to help shape public health and medical studies with an emphasis on managed care and its effect on minority populations.

This month, the institute's nine-member staff will start to analyze data centering on the status of Maryland's Medicaid recipients, beginning before managed care took hold of the health care industry in 1992 through the present.

"The world is changing," said Dr. Georges C. Benjamin, deputy secretary for public health services for the state health department. "We have to understand what it takes to eliminate ** racial and ethnic disparity in health care. Our strategies must be bold. We have to understand whether our social policy makes sense or not."

Mortality rates

A fall 1997 study by the U.S. Department of Health and Human Services showed that mortality rates for blacks continue to be about 60 percent higher than for whites. In 1992, 66,000 African-Americans died who otherwise would have lived had the African-American mortality rate been the same as for whites.

Researchers also have noted other health care disparities: 34 percent more black women die of breast cancer than white women; Native American toddlers die at almost twice the rate of white children; and Chinese-Americans are more likely than any other ethnic group to develop liver cancer and die from it.

Most recently, racial differences have led physicians to discover a person's ethnicity also might influence how medicine works. University of Maryland School of Medicine researchers last year reported at an international conference on race and health that two of the most commonly used drugs for high blood pressure are less effective in blacks than in whites, mainly because of African-Americans' sensitivity to salt.

Gap in hypertension

Researchers also have noted a significant race gap in treatment for hypertension. In the United States, high blood pressure starts at least a decade earlier among African-Americans than it does for whites. Blacks also get more complications, such as stroke, heart failure and kidney failure, and studies show that although blacks make up 13 percent of the population, they account for 50 percent of patients who need dialysis.

"We live sicker and die younger than any other ethnic group today," said Thomas LaVeist, of the Johns Hopkins School of Hygiene and Public Health, who is black. "To my mind, that is the single question facing public health today."

Added Jenkins, of the CDC, trying to explain the health gap between whites and blacks: "There are two factors we know little about -- racism and how it affects the status of African-Americans and culture. Most African-Americans don't understand the extent to which they are African."

Pub Date: 1/13/98

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