Baton Rouge physician, Grammy winner BeBe Winans add voice to the Power to End Stroke campaign

More than 100,000 African Americans have a stroke every year and are almost twice as likely to have a stroke compared to Caucasians.

But stroke is avoidable. For this reason, the American Stroke Association initiated the Power to End Stroke campaign including me and Gospel artist BeBe Winans.

As you know, I returned to my hometown of Baton Rouge after graduating from medical school and began championing health awareness by frequently taking health-conscious messages to local schools, organizations, conferences, and prisons. Dubbed “Tha' Hip Hop Doc,” I've taken the cue from many of you and decided to made good use of this newfound "fame" in joining the ASA Power to End Stroke campaign.

Last month, I joined BeBe Winans, the impassioned tenor who has won four Grammy Awards, to add voice to the campaign.

Both BeBe and I are concerned about the alarming number of lives ended as a result of a stroke. And, what's most troubling is the fact that a stroke doesn’t have to be debilitating or deadly.

If more people know their risks, control risk factors—such as high blood pressure and diabetes—and work with their doctor to eliminate or manage your risks, they may prevent stroke.

If you know the warning signs and get prompt medical attention, rehabilitation and survival are possible—even probable. But many people don’t know what to look for or what the risks are.

BeBe and I took the camera to urge you and other Americans to call the American Stroke Association at (888) 4-STROKE or visit Stroke Association.org/power to learn signs and risks of stroke. The Power to End Stroke campaign is supported nationally by the Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership.

Diabetes: Lil Boosie Speaks Out and Gives Back

Diabetes: Lil Boosie Speaks Out and Gives Back

It was funny how I met Torrence Hatch, a.k.a Lil Boosie. I was participating in a parade in Baton Rouge, LA and I saw one of my father’s former employees, a friend of the family, and someone that I love like a mother. 

 “Doc, it’s T-Pam!  Throw me some beads.”  Ms. Pam Sterling (T-Pam) is one of the most beautiful people in the world with a heart of gold. She is also one of the few people in this world who was not/is not intimidated by my father. “I need to talk to you. I want to bring my nephew in for an appointment. He has diabetes!” 

 “No problem T. You know I got you,” I replied.

 Within two weeks, Lil Boosie showed up my office with his mother Connie Hatch and T-Pam, and the friendship began.

 As popular as he is in the Baton Rouge and all over the country now, Lil Boosie is no different than the 3.2 million African-Americans age 20 and older in this country who are living with this diabetes. 

 Diabetes!  I hate that word, especially as it relates to African-Americans. Here are some other shocking numbers that may explain my disgust with the disease which can cause blindness, kidney failure, amputations, heart disease and stroke, and irreversible nerve damage: 

 African Americans are two times more likely to have diabetes than non-Hispanic whites

25% of African Americans ages 65 to 74 have diabetes

One in four African-American women over age 55 have this disease

 Time to learn more about the disease that is take the limbs, life and love out of our country like a serial killer.

 It took a while to pin Lil Boosie down for this interview. He is constantly on the grind and hardly ever sits still. My video man, photographer and good friend, Sean Griffin and I pulled up at Lil Boosie’s home around 6:30pm three days before Easter. There were two U-Haul trucks in the driveway and bicycles all over the front yard. 

 T-Pam met us at the door. When we walked in, large bags met us and were being filled with clothes. Boosie was speaking to a film crew and waiting on Foxx and Big Head, two of Trill Entertainments finest, to arrive so they could finish shooting the last scene in his movie Ghetto Times at his home.

 “Doc, come meet Mike,” he shouted out.  I walked into the kitchen looking out at his newly built swimming pool and there, sitting at the kitchen table was one of my favorite comedians, Mike Epps.

 “This is my doctor Mike,” he said. I couldn’t help but laugh and think about all the crazy roles Epps has played. Epps wanted to stay for the interview, but was getting ready for his tour, so he left shortly after we met. I kissed Lil Boosie’s mom and all his beautiful aunts on the cheek, shook hands with all the boys, kicked it with Heavy D (his favorite Uncle) for a minute, and played with his beautiful daughter.

 Finally, Sean and I headed upstairs past the beautiful playroom and through the home theater (off the chain!) to his home studio to discuss our serious topic.

 Whitfield:  Man, I really appreciate this. First of all, I come to the crib, pull in the drive way, and you have about 1500 bicycles out there and clothes all over the house… What’s going on with that?

 Lil Boosie:  We have an Easter Egg Hunt and give away. I’ve been doing this every year in honor of my boy Ivy who was killed. He used to do this community event and I’m going to keep it going in his honor. We give away like $20,000 dollars worth of bikes, $15,000 dollars worth of clothes, $15,000 dollars worth of food like BBQ and crawfish; the finders of the silver, gold, and platinum egg get $250, $500, and $1000. 

 We just giving back to the community. [Last I heard, he spent well over $55,000]  The kids have to bring their grades out on Sunday morning. If they are good, they get a bike.  If they are not so good, they probably still get a bike. If they are terrible, they get a toy.  T-Pam and momma ain’t that nice. [laughs] Really, I’m just doing this for blessings and to make other people smile. I’m blessed and I’m happy. I got the money to do this and it needs to be done.

 Whitfield:  The word is that they will have children with disabilities at the event and some kids that never had a bike. Man, that’s a beautiful thing. Now you said “it needs to be done”.  What needs to be done? You mean uplift the community?

 Lil Boosie: Yeah, I’m really doing this for the community showing my supporters I have a heart and love for all those who support me.

 Whitfield: Real talk!  When I talk to the young students and the older folks in the community, many of them don’t know “the real” Lil Boosie; they don’t know about all of the good things you do; too much emphasis on the negative.

 Lil Boosie: Yep!  I’m going to do me though Doc. Can’t worry about the haters.

 Whitfield: So let us get to what we really came to talk about - diabetes!  It’s killing African-Americans!  Not only is it killing us, but also it is a major cause of disability.  You have been diabetic for how long? 

 Lil Boosie: I been diagnosed with type one diabetes four and a half years now; I got diagnosed when I was 20, and you know it’s been a struggle for me. As the years go on though, I learn more about the disease and I get better with it, you know.

 Whitfield: You take pills and you are “on the needle?”

 Lil Boosie: Yeah, I’m taking a pill called Actos and I’m on that 70/30 also.

 Whitfield: So you are talking about insulin when you say 70/30?

 Lil Boosie: Yeah, the needle Doc. Have to give myself shots at least twice a day and check my sugar as well. 

 Whitfield: You have to check your sugar and give yourself shots every day? So how do you deal with needles on a daily basis?

 Lil Boosie: It gets old, but I know the importance of taking care of myself. You know really I just keep fresh alcohol pads and I have to alternate spots on my body where I give myself insulin injections. I use to get knots under my skin that were painful, so now I go to my arm one day, stomach the next…

 Whitfield: What’s the difference in type one diabetes and type two diabetes?

 Lil Boosie: Well basically I have type one, which happens, in general in younger patients.   [Type one diabetics] don’t make insulin, which helps bring down your blood sugar.  Older people in general get type two diabetes; they make insulin but the body can’t use it properly.  That’s the way I understand it.  If I’m wrong, then blame yourself ‘cause you told me. [laughs]

 Whitfield:  I’m a damn good teacher. [laughs]  So, do you ever have days where you say, I’m tired of this, I’m not dealing with this, I’m not going to eat right or exercise?

 Lil Boosie: [smiles] Yeah man, I have days when it’s like all falling down on me. If I like go two to three weeks of taking care of myself, that one day I slip, I might get sick. You know I have to really be on it and the lifestyle I have - this lifestyle I’m surrounded by, you know, I feel like I need more people around to help me with this. It’s hard Doc. You know those couple of nights I had to call you when I’m on the road feeling bad; sh*t man, I was down. But it’s all good when I take care of myself.

 Whitfield: How does it feel to be young, Black, living with diabetes and being able to speak out about it to young people?

 Lil Boosie: At first it was like, how am I going to accept it? But now I talk about the disease and motivate other diabetics to take care of themselves and prolong their lives.  It’s like a blessing; at first it felt like a curse, but now, to me it’s like a blessing.  It’s millions of people with this disease and I’m a big influence to a lot of people. So, if I can help people to live longer by talking about it, then I’m going to keep doing it.

 Whitfield: Do you think it is important that artist speak out about health issues? 

 Lil Boosie: I think it’s very important!  Especially when it comes to Hip-Hop. Hip-Hop influences children and adults. I feel like if you have the position or the power to make people listen to you, you should do it in a positive way with your music and your voice.

 Whitfield: What’s next for Lil Boosie?

 Lil Boosie: I got my album coming out called Return of Boosie Badd Azz; I got my movie coming out Ghetto Stories; I’m shopping clothing line deals, I just ain’t got the check yet [smiles and laughs]; waiting on somebody to cut the check; and I’m just working harder than every body. 

 I got my own in-house studio, putting out mix tapes. I’m doing my own publishing and producing my own music. Right now I’m just ahead of the game ‘cause I’m on demand for shows. I get a lot of show money. 

 Whitfield: That’s what’s up! Who is your favorite artist in the game?

 Lil Boosie: Ice Cube! See how I’m doing movies? Look what Cube did. Yeah, he was doing gangsta rap, but he was also using his mind. He didn’t just rap his way through it he used his mind.

 Whitfield: Yeah, Cube did and is still doing his thing. He has a new album coming out.  I’m still tripping on Mike Epps in your kitchen, that’s a funny dude. [laughs]  Well homie, anything else you want to say to those with diabetes and to those who are trying to come up in this music game?

 Lil Boosie: I know this, diabetes is not HIV; it’s not AIDS. Take care of yourself, keep your sugar under control, and you can live better and longer. Keep your head up and take pride in your self. Don’t feel like you are alone with diabetes. God has blessed you, so take pride in your self. 

 As far as music, you got to be dedicated. You got to want it more than anybody. You have to be talented and use your talent; learn how to put music together, learn how to carry yourself around people, and learn and live like you are a superstar. Believe that sh*t!  Plus there is stuff you can’t do when you get to this level. Listen to those around you who have been in the game.

Check our Dr. Whitfield with Lil' Boosie at www.h2doc.com/main/inside/php?section=multimedia&page.video.

Sleep Apnea: The Silent Killer

Sleep is a basic human need and is important for our mind and bodies to function normally.

Sleepiness due to a lack of adequate sleep is a big problem in the United States and affects children as well as adults. In general, children and adolescents need at least 9 hours of sleep each night to do their best, while adults need approximately 8 hours of sleep each night. There are many reasons for inadequate sleep such as anxiety disorders, use and abuse of certain stimulants such as caffeine, medicines for weight loss or attention deficit disorder, and alcohol abuse to name a few. However, there is one problem that, if not addressed, can be a cause of many health related issues. A disorder that often goes unrecognized because it’s happening while the victim thinks he is resting.

This silent killer is called sleep apnea.It is estimated that there are 18 million people in the United States who are living with diagnosed cases of sleep apnea, but many more are undiagnosed.

We all are familiar with National Football League legend and hall of fame honoree Reggie White, actor John Candy, comedian Rosie O’Donnel, and best-selling author Anne Rice. Each suffered from this often missed and under-treated disease.Maybe if more people understood the relationship between sleep apnea, being overweight, and how they all relate to high blood pressure, heart disease, diabetes, and strokes, they would live longer and healthier lives.

Sleep apnea, in its simplest definition, means that a person’s breathing is interrupted while he is attempting to get some Zs. Some individuals will not breathe for 20 - 30 seconds before “coming up” for air. The family and significant others describe the sleep of these individuals with terms like, “loud snoring, restlessness, gasping for air, and sounds of choking”. Most patients complain of daytime fatigue and falling to sleep or dozing off while at work or driving.The short term problems are obvious and range from being kicked out of bed by your spouse, losing your job or killing yourself or another driver. The questions I’m often asked are, “How does sleep apnea happen” and “is it treatable?”

There are two types of sleep apnea: obstructive sleep apnea (OSA) and central sleep apnea (CSA). Obstructive sleep apnea is the most common form and is caused by a blockage of the airways. This usually occurs when the tissues of the neck and throat collapse during sleep. In CSA, there is no airway blockage, but the brain fails to signal the muscles to breathe during sleep.There can also be a mixed picture where both central and obstructive sleep apnea exist together.

Risk factors for sleep apnea include: being male, being overweight, being over the age of 40, having enlarged tonsilshaving a large neck size (greater than 17” in men and 16” in women), or having a family history of sleep apnea.

When a person with sleep apnea stops breathing, the body has a reflex that will wake them up. The patient does this all through the night and rises the next morning feeling tired and sleepy. During these periods of apnea (which means not breathing) the body is deprived of oxygen to the brain and tissues.The response is an increase in red blood cells, that carry oxygen, and over time the blood gets thick and sluggish. If blood flow to the brain or heart is not adequate, a heart attack or stroke can result.To diagnosis sleep apnea, my patients are referred to an ear, nose and throat (ENT) specialist and sent for a sleep study or polysonogram (PSG). The ENT specialist will evaluate the patients for correctable causes of sleep apnea. If the soft tissue in the throat is too thick, the septum in the nose is deviated, or other facial abnormalities exist, these can be surgically corrected.The sleep study is designed to detect other causes of sleep disorders, like restless legs syndrome, and to guide sleep specialist in treatment regimens for the disease. A PSG involves going to a lab and sleeping. Sounds easy, but with electrodes over your body and someone analyzing your sleep, it may be a little uncomfortable.

Once the diagnosis is made, conservative treatment options include aggressive weight loss, avoiding sedatives like codeine, alcohol, and sleeping pills, smoking cessation (smoke increases airway swelling), and avoiding sleeping on your back. If attempts at weight loss are unsuccessful, surgical procedures are often considered. A consultation with a board certified surgeon who specializes in bariatric surgery (weight loss surgery) is the only way to go. One of the most common non-surgical forms of treatment includes wearing a mask at night that will keep the airways open. This treatment is called Continuous Positive Airway Pressure (CPAP).

The mask covers the nose and mouth while you sleep, and is connected to a machine that delivers a continuous flow of air, maintaining an open airway. Special dental devices can be designed to keep the airway open as well as the surgical procedures mentioned earlier.There is even a medication called Provigil that some physicians use to treat the daytime fatigue and tiredness, but this is usually in combination with CPAP and good sleep hygiene. Many people are resistant to using their CPAP machine, and although cumbersome, it could very well save your life.

If you have any of the signs and symptoms above, see your physician right away, improve your sleep, and get back in bed with the one you love.

For more information on sleep apnea visit http://www.sleepapnea.org. (c) 2008 Rani Whitfield. Published May 2008 in New View magazine.

Big Pun, Pimp C and You - Real Talk About Sleep Apnea

“Damn, homie! Get up! Roll over or do something! I can’t sleep with you making all that noise. Sounds like you about to suffocate or die or something.” These were actually my words, (minus a few explicative comments) to my roommate and the leading scorer on our basketball team during my freshman year in junior college.

Dude snored so bad that my coach finally put him in his own room, after moving him twice, so my other teammates could get some rest.

Everybody thought it was funny, unless you had to share a room with him.

It was great once he got his own dorm room; we could sleep and he could sleep in peace - or could he?

None of us knew that we were witnessing a potentially life threatening problem. A problem that often goes unrecognized because it’s happening while the victim thinks he is resting. This silent killer is called sleep apnea.

It is estimated that there are 18 million people in the United States (US) who are living with diagnosed cases of sleep apnea with many more undiagnosed. We all are familiar with National Football League legend and hall of fame honoree Reggie White, Chad “Pimp C” Butler, and Christopher “Big Pun” Rios. Each suffered from this often missed and under-treated disease. All of them died way too young.

Maybe if Pimp C knew more about the deadly combination of mixing his breath-slowing cough syrup with this disorder, he would still be alive. Maybe if Big Pun understood the relationship between sleep apnea, being overweight, and how they all relate to high blood pressure, heart disease, diabetes, and strokes he would be alive. And maybe, just maybe, if the NFL did not require linemen to average over 300 pounds or be financially penalized, traded or fired for being “underweight,” Reggie White would still be around…

Sleep apnea, in its simplest definition, means that a person’s breathing is interrupted while he is attempting to get some z’s. Some individuals will not breathe for 20 to 30 seconds before “coming up” for air. The family and significant others describe the sleep of these individuals with terms like, “loud snoring, restlessness, gasping for air, and sounds of choking”. Most patients complain of daytime fatigue and falling to sleep or dozing off while at work or driving.

The short term problems are obvious, and range from being kicked out of bed by your lady, losing your job or killing yourself or another driver. The questions I’m often asked are, “How does sleep apnea happen” and “Is it treatable?”

There are two types of sleep apnea: Obstructive Sleep Apnea (OSA) and Central Sleep Apnea (CSA). Obstructive Sleep Apnea is the most common form, and is caused by a blockage of the airways. This usually occurs when the tissues of the neck and throat collapse during sleep. In CSA, there is no airway blockage, but the brain fails to signal the muscles to breathe during sleep.

There can also be a mixed picture where both Central and Obstructive Sleep Apnea exist together. Risk factors for sleep apnea include:
male gender
being overweight
being over the age of 40
having enlarged tonsils
having a large neck size (greater than 17” in men and 16” in women)
having a family history of sleep apnea

When a person with sleep apnea stops breathing, the body has a reflex that will wake them up. The patient does this all through the night and rises the next morning feeling tired and sleepy. During these periods of apnea (which means not breathing) the body is deprived of oxygen to the brain and tissues.

The response is an increase in red blood cells, that carry oxygen, and over time the blood gets thick and sluggish. If blood flow to the brain or heart is not adequate, a heart attack or stroke can result.

To diagnosis sleep apnea, my patients are referred to an ear, nose and throat (ENT) specialist and sent for a sleep study or polysonogram (PSG). The ENT specialist will evaluate the patients for correctable causes of sleep apnea. If the soft tissue in the throat is too thick, the septum in the nose is deviated, or other facial abnormalities exist, these can be surgically corrected.

The sleep study is designed to detect other causes of sleep disorders, like restless legs syndrome, and to guide sleep specialist in treatment regimens for the disease. A PSG involves going to a lab and sleeping. Sounds easy, but with electrodes over your body and someone analyzing your sleep, it may be a little uncomfortable.

Once the diagnosis is made, conservative treatment options include weight loss, avoiding sedatives like codeine, alcohol, and sleeping pills, smoking cessation (smoke increases airway swelling), and avoiding sleeping on your back.

One of the most common forms of treatment includes wearing a mask at night that will keep the airways open. This treatment is called Continuous Positive Airway Pressure (CPAP). The mask covers the nose and mouth while you sleep, and is connected to a machine that delivers a continuous flow of air, maintaining an open airway. Special dental devices can be designed to keep the airway open as well as the surgical procedures mentioned earlier.

There is even a medication called Provigil that some physicians use to treat the daytime fatigue and tiredness, but this is usually in combination with CPAP and good sleep hygiene. Many people are resistant to using their CPAP machine, and although cumbersome, it could very well save your life.

If you have any of the signs and symptoms above, see your physician right away, improve your sleep, and get back in bed with the one you love.

And by the way, my former roommate wears his CPAP and is doing well…

For more information on sleep apnea visit http://www.sleepapnea.org/or read about Pimp C at www.pimpcmusic.com (c) 2008 Rani Whitfield. Published April 29, 2008 at www.allhiphop.com

Straight Sippin: Killing Us Softly

“It taste great doc! I don’t even drink on that Henn anymore. You should try it; taste better than any margarita I’ve ever had. Just give me a cream soda or some fruit punch, mix it with that purple, and it’s on!”

This was only part of a conversation I had with a patient who tried in every way possible to get me to write him a prescription for a pint of “lean,” “purple” or what we call in the medical community, Promethazine with codeine (PC).
The street value for a pint of undiluted PC is $500, but more often this pint is “cut” with Karo syrup by the local street pharmacists to “stretch it out.” A gallon of PC “stretched out” can generate well over $3600 dollars on the streets.

In addition to being lucrative for the street pharmacists, the presence of “dat syrup,” “sizzurp” or “lean” was made popular by DJ Screw and the Houston Hip-Hop culture, and it became a common social drink among young African-Americans all across the nation.
References to PC are common in songs like Three 6 Mafia’s “Sippin’ on Some Sizzurp” and Lil Wayne’s freestyle rap “Live From 504.” As popularity increases for PC, the question arises, Why are people obsessed with PC? Answer: It’s the codeine!

Codeine, a commonly prescribed and effective drug used to treat pain, diarrhea and to suppress cough, is the most widely used and naturally occurring opiod or narcotic (medicines that produce pleasure and calmness) in the world. It comes from the opium poppy, and is related to morphine and heroin.

Codeine is also the base material for the production of two other narcotics, hydrocodone and dihydrocodeine. Compared to morphine, codeine produces less pain relief, and is usually taken by mouth in liquid or tablet form. It is often combined with aspirin or acetaminophen (Tylenol) to enhance its affects on the body. Promethazine, which does not contain codeine, is the generic name for a sedating, anti-nausea chemical this is often combined with codeine in cough syrups.

The combination of promethazine with codeine to control cough and cold symptoms is very effective when used properly, but can become addictive and dangerous when misused because of the codeine. Most Americans take their medications responsibly, however in 2003, approximately 15 million people in the United States reported using a prescription drug for non-medical reasons at least once during the year.

Prescription drug abuse has become a problem for several reasons. Use of prescription drugs is viewed as safe because a doctor prescribed it; it is readily accessible in home medicine cabinets; and medicines that normally need a prescription can now be purchased online without seeing a doctor, thus lessening the chance that one could get caught by the authorities for purchasing and using an illegal substance.

The three types of drugs commonly misused or abused in this country include:
opioids - which are prescribed for pain relief central nervous system depressants - often referred to as sedatives or tranquilizers (i.e. barbiturates and benzodiazepines) which are prescribed for anxiety or sleep problems
stimulants - which are prescribed for attention-deficit hyperactivity disorder (ADHD), the sleep disorder narcolepsy, or obesity

Symptoms of overdose on opiods like codeine include constipation, slow breathing, seizures, dizziness, weakness, confusion, tiredness, cold and clammy skin, small or constricted pupils, loss of consciousness, coma and possibly death!

To experience the effects of codeine, the human body must convert the drug to morphine. The effects of codeine start 10 to 30 minutes after ingestion, peak within one to two hours, and may last four to six hours, depending on how much is taken. Within two to three weeks of repetitive use, a physical and psychological addiction may develop. Misuse will lead to an apathetic, dulling-type effect, a lack of co-ordination and dulled responses.

The effects of the misuse of prescription drugs are not limited to just those that are of middle or lower income, there are popular artists that have also suffered the repercussions of misusing these drugs.

The cause of death for Robert Earl Davis, Jr., also known as DJ Screw, at age 30 was attributed to the result of combining PC with marijuana and alcohol.

Unfounded rumors have circulated about Pimp C’s death being related to an overdose of PC, however the autopsy results show that the PC only contributed to his death. Pimp C had a condition called sleep apnea (which we will talk about in my next article) that did not mix well with the cough syrup. Together, they caused his death.

The bottom line is that, recreational use of PC is dangerous, addictive, potentially life threatening, and illegal to use without a prescription. Be careful what you sip…it could be your last. (c) 2008 Rani Whitfield. This article was published April 2008 at http://allhiphop.com.

Who are the Uninsured in America?

The uninsured are tossed around like pawns on a chess board, but most do not have an idea of who the uninsured are and how they became part of this faceless roll that houses these people. In order to understand why it is imperative that legislation be put in place that assist them, let’s take time to pull back the curtain of mystique on globally grouping the uninsured as the “have” and “have nots” and hear the story of my patient Ms. G. Ms. G is a 59-year-old African-American woman who works as a cook at a local day care here in Baton Rouge, LA.

Contrary to public opinion, Ms. G has been employed all of her life as a cook and has held her current job for thirteen years. She was referred to me after being evaluated in the emergency room for an elevated blood pressure, elevated blood sugar, and headaches. The emergency room doctor insisted that she seek the services of a primary care physician and get her blood pressure and blood sugar under control, or suffer the repercussions of these health conditions- a heart attack or stroke. Physically, Ms. G is in poor health but with some changes her health outlook could improve. She is a slightly over weight smoker with a strong family history of heart disease and diabetes. Her mother and father died from complications of heart disease, and her younger sister recently died from a massive heart attack.

Her options for treatment were limited to the local charity hospital, which has eliminated the outpatient family practice clinic due to budget cuts. Before the clinic discontinued its services there was a typical wait of four to six months for a routine appointment. This wait was so prohibitive she has never followed up with a physician for “scheduled visits” after her initial emergency room visits. In addition to simply accessing healthcare, the price tag for maintenance of ones health is unreasonable. The average cost for an appointment with a primary care doctor for cash-paying patients that includes blood work and other tests ranges from $200-400 dollars, but I have seen her in my office free of charge.

Prior to her visit at my office, the emergency room had become her primary care doctor and she was very appreciative of seeing a “regular” doctor. Because Ms. G lives just above the poverty level and, as she puts it, “robs Peter to pay Paul”, she has never been able to afford health care insurance and has placed eating, paying the bills, and helping to raise her grandchildren as a priority over her own health. “I gotta live Doc. Maybe I will get some insurance later; but right now, I gotta live.” Later may just be “too late” for Ms. G. Without medical intervention and a consistent health care program maintained by a physician, her risk for heart disease and stroke are high.

Although Ms. G’s story is sad, unfortunately, her story is a very common and frustrating problem for both physicians and patients. There are more than forty million uninsured people that live in the United States, which is twenty- percent of the U. S. population. In 2005, one in five Americans under the age of sixty-five did not have health insurance. This number has continued to increase which was reinforced by findings released on December 3, 2007 by the CDC entitled Health United States 2007, which showed that one-fifth of Americans could not afford one or more of the following services: medical care, mental health services, prescription medicines, eyeglasses, or dental care.

Since the release of Michael Moore’s controversial and thought provoking documentary Sicko which addresses the state of health care in the United States, this topic has spawned much debate: how many people are uninsured in America, forty-seven million or thirty-seven million; does that include the illegal immigrants; is universal health care really cost effective; who’s healthier, Michael Moore or Sanjay Gupta? Who cares! One uninsured or under-insured American is one too many!

The face of the uninsured may not be what you think. Those without health insurance do live significantly below the poverty level, however nearly seventy- percent live in homes with at least one full-time worker. Health insurance is either not offered by the employer or the percentage that the worker is asked to pay towards insurance premiums is too expensive. Medicaid and the State Children’s Health Insurance Program have reduced the number of uninsured children under the age of nineteen; nevertheless, more than eight million children, three-quarters of whom qualify for these programs, still are not insured. Young adults between the ages of nineteen and twenty-nine with low income and unstable jobs are the fastest growing population of uninsured in America.

In a poll by the Henry J. Kaiser Family Foundation, voters rated health care second only to the war in Iraq as the issue they most wanted the presidential candidates to address. Seventy-four percent of voters supported a reform plan that provided health insurance for everyone. The time has come for universal and affordable health care. I don’t have all the answers, but this crisis needs to be addressed and should be of the highest priority for the presidential candidates as these nameless people are their constituents and an integral part of the fabric of this country. (c) 2008 Rani Whitfield. This article was published March 2008 at http://www.eurweb.com.