Don’t be Black and Get Sick
The title of this post could easily read, Don’t be [insert minority status here] and Get Sick.
The truth is, if you are from a racial, ethnic, or social minority group in the United States, there is a good chance that your health status could be affected simply by your status as a minority. This is what academics call health disparities. The government defines health disparities like this:
Health disparities are differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States.
The Centers for Disease Control puts it more plainly:
Health disparities are the persistent gaps between the health status of minorities and non-minorities in the United States.
What this means is that not only African Americans experience health disparities. Latinos, Native Americans, and others also experience them. For example, if you are poor or uninsured, you are more likely to experience a health disparity. Differences may occur by gender, race or ethnicity, education or income, disability, geographic location or sexual orientation.
The U.S. Department of Health & Human Services notes that two major factors leading to health disparities include inadequate access to care and substandard quality of care. So members of minority populations are less likely to have access to care, and when they do, the care is oftentimes of lesser quality than what their non-minority neighbors receive.
Some examples of health disparities include:
From the National Cancer Institute:
- Blacks are more likely to die from cancer than are whites, or other groups.
- While African American women are less likely to develop breast cancer than are whites, they are less likely to be alive five years after being diagnosed.
- Hispanic women have over two times the rate of invasive cervical cancer occurance, compared to whites.
- Native Hawaiians have an 18 percent lower survival rate from any cancer, compared with whites.
- Native Americans and Alaska Natives have the poorest survival from cancer, compared to any other group.
From the CDC:
- In 2002, non-Hispanic blacks who died from HIV disease had approximately 11 times as many age-adjusted years of potential life lost before age 75 years per 100,000 population as non-Hispanic whites.
- Gay men, blacks, and Hispanics continue to be disproportionately affected by HIV/AIDS, viral hepatitis, STDs, and TB.
- Regarding asthma management, blacks are less likely than whites to receive controller medications.
- For Hispanics, not having health insurance and a usual source of care is getting worse.
- For the poor, not having a usual source of care and experiencing delays in care is getting worse.
There are complex models of why health disparities exist, why they persist despite efforts to reduce them, and what things are most effective at having an impact. Certainly our individual behavior affects our health, but oftentimes our behavior is shaped by our environment, what we observe through learning, what our teachers tell us in school, and what we experience (or don’t experience) in our homes. This is really the classic nature-nurture question, applied to our health.
The fact remains that even when you remove “from the equation” variables such as income, educational levels, and past health history, health disparities persist. When you remove the influence of access to care, which usually isn’t a problem for educated and non-poor minority persons, health disparities remain. This puts the focus squarely on the quality of the care that minorities receive.
If you are African American, Native American, Latino, poor, or live in an urban area–just to name a few–the quality of the health care services you get may be lower than it should be. This is a problem that the health professions must address through the education of their students, but we each have a responsibiilty as well. We have a responsiblity to ask the right questions, seek out advice when something doesn’t seem right, be persistent when we feel we feel we aren’t getting the best care, and to not be afraid to do this for others.
Addressing health and health care disparities will take time, but the momentum is here, and awareness is important to making real change happen. You are important to making real change happen.
Unnatural Causes: Documentary on the role of inequality in health disparities.
Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care: Report from the Institute of Medicine on health disparities.
What is a Health Disparity?: Journal article from the journal, Public Health Reports, September-October 2002 issue.
Dr. Darrell Spurlock teaches nursing and psychology in Columbus, Ohio.
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