Health care disparities heighten disease differences between Black and white Americans.
It’s been established that there are several deadly diseases that Blacks have a greater propensity for which they suffer with greater intensity.
The reality is that there are some arbitrary issues that are present in the way medicine is practiced in America, and in which it doles out health care. Close examination reveals the very volatile issue of race and what race means. At the end of the day, all of us acknowledge that race is a very poor physiological construct. Race is a placeholder for something else. That something is less likely to be genetic. It is more likely to have to do with socioeconomics and political issues of bias as well as physiological and genetic issues that go into that same bucket. Some racial differences are mere nuances. But there are real issues of disparity as a consequence of race, and there are issues relative to racism that operate in a very broad context.
Yet, we’re nowhere near the end of the fight. Some numbers:
- Diabetes is 60 percent more common in Black Americans than in white Americans. Blacks are up to 2.5 times more likely to suffer a limb amputation and up to 5.6 times more likely to suffer kidney disease than other people with diabetes.
- African-Americans are three times more likely to die of asthma than white Americans.
- Deaths from lung scarring – sarcoidosis – are 16 times more common among Blacks than among whites. The disease killed former NFL star Reggie White at age 43.
- Despite lower tobacco exposure, Black men are 50 percent more likely than white men to get lung cancer.
- Strokes kill four times more 35- to 54-year-old Blacks than whites. Blacks have nearly twice the first-time stroke risk of whites.
- Blacks develop high blood pressure earlier in life – and with much higher blood pressure levels – than whites. Nearly 42 percent of Black men and more than 45 percent of Black women aged 20 and older have high blood pressure.
- Cancer treatment is equally successful for all races. Yet, Black men have a 40 percent higher cancer death rate than white men. Black women have a 20 percent higher cancer death rate than white women.
Why?
Genes definitely play a role. So does the environment in which people live, socioeconomic status, and, yes, racism. Science indicates that all humans have the same physiology, are vulnerable to the same illnesses, and respond to the same medicines. Naturally, diseases and responses to treatment do vary from person to person. But there are unique issues that affect Black Americans.
There is no better time than now for Americans to face these issues and move to transform the way health care has traditionally been managed.
In Dr. Herman Bell, D.O.’s autobiography, he calls on physicians to be more impassioned, particularly where health disparities are concerned and how they impact our communities. He reminds us that the evil origins of institutionalized racism seep into our everyday lives and reminds doctors to spend more time recognizing the disparities and addressing them with their patients – as it pertains specifically to them – to empower and give the responsibility of their well-being back to them.
Black Americans and Lung Disease
As recently as 2005, the American Lung Association reports that Blacks suffer far more lung disease than whites and other respiratory related diseases
Some of the findings:
- Blacks have more asthma than any racial or ethnic group in America and are three times more likely to die of asthma than whites.
- Blacks are three times more likely to suffer sarcoidosis than white Americans. The lung-scarring disease is 16 times more deadly for Blacks than for whites.
- Black children are three times as likely as white American children to have sleep apnea.
- Black babies die of sudden infant death syndrome (SIDS) 2.5 times as often as white American babies.
- Black men are 50 percent more likely to get lung cancer than white American men.
- Blacks are half as likely to get flu and pneumonia vaccinations as white Americans.
African-Americans and Heart Disease, Stroke
- Heart disease and stroke disproportionately affect African-Americans. Why?
- The more aggressive and higher incidence of heart disease in Blacks is set in motion by the very high incidence of high blood pressure Blacks experience This predisposes Blacks to more heart disease, kidney disease and stroke. Blacks are much more likely to experience heart failure without having a previous heart disease. The focus on high blood pressure in Blacks as a preventive measure is important as it forces heart failure.
- Clinical trials show Blacks and whites respond differently to treatments for high blood pressure. Indeed, treatment guidelines suggest that doctors should consider different drugs based on a patient’s race.
- A closer look at the data shows that race tends to be a marker for more complicated high blood pressure treatment.
- Black and Mexican-Americans have twice the risk of diabetes as white Americans. In addition, Blacks with diabetes have more serious complications – such as loss of vision, loss of limbs, and kidney failure – than whites.
Black Americans and Sickle Cell Anemia
- Sickle cell anemia affects Blacks far more than it does whites.
- This, clearly, is a genetic disease that has little to do with the environment. Yet, even here – with a killer disease – social and political issues come into play.
- The cause of sickle cell anemia has been known since the 1950s. Yet, sickle cell anemia has not had the funding and research attention it deserves.
- There are actually more Americans with sickle cell disease than with cystic fibrosis– 65,000 to 80,000 vs. 35,000 to 40,000 – but the amount of money spent on cystic fibrosis research outstrips sickle cell anemia.
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