Thursday, March 15, 2007

Disparities in healthcare

Black America, we have a problem.

Despite what you might think, things are not equal, especially when it comes to health and health care. HIV/AIDS, heart disease, strokes, high blood pressure, colon and rectal cancer, prostate cancer, obesity, and diabetes affect our race at much higher rates than other ethnic/racial groups. Just name a disease and African Americans are probably the most affected population. What’s more alarming is that often despite a good education and quality insurance, stereotyping and biases on behalf of the health care provider can still add up to unequal treatment and sub-par medical care. But its not just African Americans, it’s the poor and uninsured that really get the shaft.

True story : I had a patient who presented to my office with signs and symptoms of a heart disease; a heart attack waiting to happen. One year prior, he had been seen in a local emergency room (ER), diagnosed with “probable” heart disease. After being observed for 23 hours he was sent home without seeing a cardiologist and told to follow up with his primary care doctor. He did not have one. He called the ER and asked what he should do, and they told him not to come to their facility because he did not have insurance. Next he came to my office to discuss his options with me, which were basically none. After our appointment I didn’t hear from him for a while, but later found out that he decided to walk around the hospital grounds until he got sweaty and tired, so that he could walk in the ER complaining of chest pain. They would have to admit him. But what actually happened was after three laps around the hospital, my patient collapsed and was literally having a heart attack. He was the happiest man in the world. He was admitted to the hospital and saw one of the best cardiologists in the city. His blood work showed that he was anemic (low blood count) and because of his age and risk factors a colonoscopy was performed by a very talented gastroenterologist (stomach doctor). However, smiles turned to frowns when he was discharged form the hospital after it was discovered that he could not afford to pay for follow up treatments. He showed up at my office again after this episode, but I never heard from him again after that visit.

This is just one example of the extreme measures the poor and uninsured in America have to take in order to receive medical attention. Sadly, I could tell you many more. Research has shown that minorities are less likely to receive routine medical procedures and quality health care than their white counterparts. So what are some solutions: better doctor-patient relationships; increase the number of minorities among health professionals providing services to minority patients; ensure that both the public and private sector have the same types of coverage; increase patient education and empower patients to better care for themselves.

Racial/ethnic disparities in healthcare are a reality associated with poor medical outcomes and even death, which are unacceptable and should not be tolerated. We, as a community, must learn to take better care of ourselves. Education and awareness about health and health care is essential to the survival of our community.

For more information on disparities in health care visit
(c) 2007. This article was published March 15, 2007 at