Unhealthy disparities

August 19, 2005

THE AVERAGE black man can expect to live about 68 years, compared with nearly 75 years for the average white man, according to the American Public Health Association. That's one reason why former U.S. Surgeon General David Satcher has joined with a group of prominent black men in Atlanta to get more black men to pay attention to their health.

That's one of many worthy efforts to do something about health disparities that result in shorter life spans and more vulnerability to diseases among minority men and women. The importance of those efforts was reconfirmed this week as three new studies documented that, despite years of being spotlighted, the disparities persist.

Several reports have found that minorities are less likely than whites to have private health insurance, and they have less access to top-notch health services and providers. But even with comparable incomes and insurance, minorities tend to receive a lower quality of care than whites for the same health conditions.

As a result of these and other factors, minorities have been found to suffer disproportionately from heart disease, diabetes, breast and cervical cancer, HIV/AIDS, infant mortality, high blood pressure and obesity. The most recent studies show that, despite some advances, blacks are still less likely to receive some common procedures such as heart bypasses, hip and knee replacements and appendectomies. One of the studies showed that, from 1999 to 2001, black men in Baltimore who were enrolled in Medicare were about 63 percent less likely than white men to have heart-bypass surgery and black women were 30 percent less likely to have the procedure than white women.

Fixing the problem of disparities requires a comprehensive approach. A proposed increase in federal spending that would allow the creation or expansion of 1,200 community health centers, where many minorities seek treatment, is a sign of progress. More public and private funding to increase diversity among all health care workers would also help break down cultural and other barriers between minorities and health care providers. At the same time, the threat of fines or loss of accreditation might force hospitals to be more diligent about addressing disparities.

In Maryland, lack of adequate funding has prevented state health officers from developing mandated plans to reduce disparities based on race, ethnicity, gender and poverty. Inadequate funding has also meant a slow start for the state's Office of Minority Health and Health Disparities that was created last year. It should surely be in the best interests of a state with top-tier medical facilities to do better.

In addition to the need for institutional changes, Dr. Satcher and others are right to encourage minority individuals to take more responsibility for their own health, including getting preventive screenings and regular check-ups. The sooner disparities in health care can be eliminated, the sooner everyone will reap the benefits.

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