yay...i want to get flamed....so i'll just put it out there.
racial and ethnic health disparities are a result of prejudice and racism.
here's some text of an article for those who are interested (its too long to fit)....
By Spring Gombe
Reprinted from METRO Exchange, March 2000
A year ago, the U.S. Centers for Disease Control and Prevention launched the REACH 2010 project. The acronym stands for Racial and Ethnic Approaches to Community Health. Its intention is to eliminate racial and ethnic disparities in health by the year 2010.
As the leader of a community-wide consortium, the Institute for Urban Family Health, a New York City based family practice organization, was one of 32 groups nation-wide to receive a grant to create a program to change health outcomes. The Institute's project focuses on diabetes and cardiovascular disease in people of color in the Southwest Bronx.
Here are some facts: Women in the Southwest Bronx have rates of death from diabetes that are close to twenty times higher than women on the Upper East Side. They are five times more likely to have preventable hospitalizations hospitalizations that could have been avoided by adequate primary and preventive health care. Overall, people in the Southwest Bronx are about twice as likely to have diabetes or hypertension, or die of heart disease. These facts echo well know national statistics that white men live, on average, ten years longer than black men; white women, six years longer than their African-American counterparts.
A group of community-based organizations in the Southwest Bronx is gearing up to change these facts. The Institute for Urban Family Health, St. Edmund Episcopal Church, Mount Hope Housing Company, the Women's Housing and Economic Development Corporation (WHEDCO), and the Center for Health and Public Service Research at New York University have joined hands to create the Bronx REACH 2010 coalition. The group has already been joined by representatives of roughly twenty more community groups. Through resources provided by CDC, this group has initiated a community- wide exploration to understand and address barriers to health. Already, we have learned that our solutions must reach far beyond the health care system itself.In a series of informal conversations with community members we have found that certain barriers to health are frequently mentioned. These include:
Poverty
"The pills cost a dollar fifty each, I take ten pills a day. I can't afford a dollar fifty each."
"They (fitness centers) want 275 dollars a year, all at once. Which person on Medicaid has 275 dollars up front? I don't have 275 dollars, that's my rent! Maybe if they said ten dollars a month
"
For the people of the Southwest Bronx, poverty is already a critical barrier to access to affordable housing, medication, health, and other social services. More than half of our community receives Medicaid. For our population, making choices in the system often means choosing between medicine and food, rent and medicine.
Getting to health centers can be difficult enough. Obtaining the best care when you are on Medicaid or uninsured can be almost impossible.
Money is also a factor in making the lifestyle changes that would contribute to a lower risk for disease healthier foods are often unavailable in our communities when they are, they are frequently priced out of reach. The same is true about fitness centers, weight loss clubs, counseling, and other services that help people make difficult lifestyle changes. Clearly, we will not reduce health differences for different populations without addressing this issue.
Stress
"Poverty, unemployment, racism, drugs, violence."
These factors came up again and again as the leading causes of stress and illness. And everyone we spoke to said they felt people of color had higher levels of stress than whites. It is commonly known that stress aggravates hypertension, which increases risk for stroke and heart attacks. The social and economic barriers to a sense of wellness could well be increasing our populations risk for disease.
If we are to combat ill health then, it seems an integrated approach will have to be taken which includes the creation of strategies to address the myriad factors that influence health which fall outside the health care system: economics and education are high on the list.
Over the years, the Mt. Hope Housing Company, St. Edmund Episcopal Church, and WHEDCO have created such initiatives as "Drugs Out" to mobilize community members to improve their living environments. Other successful initiatives include housing, daycare, employment and after-school programs. These organizations' partnership in the Bronx REACH 2010 consortium is an outgrowth of their commitment to improving community life and making the Bronx a safe and attractive place for families, individuals and investment. With effort, we hope it will be a healthier place too.
Trust
"Doctors come here to train on us, and then go somewhere else to practice."
The issue of trust has been raised on several occasions, and is a pivotal one for the African American community. Who does not remember the Tuskegee study? Learning about the study, and other similar events, is an integral part of African-American history. More current research, including a recent study on cardiovascular disease, confirms that African-Americans receive worse care than their white counterparts, even when they have the same income, insurance, and medical history. The impact is devastating. Not only do African-Americans live shorter lives than whites, they suffer worse health care outcomes on a variety of measures. If they are diabetic, they are more likely to have limbs amputated; if they have breast cancer, they are more likely to die. Yet, if their justified mistrust causes African-Americans to avoid the health care system altogether, the result only aggravates the problem.
Health Care System
"I haven't been to the doctor since 1991"
"I feel like a mutt or some kind of jackass when I go."
These were some of the responses we got to a question about how people felt when they last saw a medical provider. More than half the people we've spoken to feel powerless and abused at the hands of the health system. Many received such poor treatment at their last visit that they have opted out of the system altogether. One person had not been to the doctor in ten years, despite a family history of diabetes. The fault lies not with the individual, but with the system.
The majority of people we've spoken to feel that they are regularly treated without respect, ignored, negatively stereotyped, given the run-around, and that staff is rude. What we have found from these conversations is paralleled by other studies. A recent Kaiser Family Foundation Survey found that one in three people of color shares this experience.
