[by Abraham L. Funchess, Jr]
“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” – Martin Luther King, Jr.
We must act now and decisively if we want to realize a significant health care package by 2010 that can alleviate massive health care burdens for ourselves and our community neighbors.
The Reverend Dr. Martin Luther King, Jr. famously said that “of all the forms of inequality, injustice in health care is the most shocking and inhumane.” Today, in February 2009, with President Barack Obama in the White House there are some who suggest that we live in a “post-racial” society. In this era of historic firsts, some question whether Black History Month has been rendered obsolete. While we joyfully acknowledge the progress our nation has made in terms of civil rights and opportunity for all, we have only to consider the quote from Dr. King to see that race still plays a role in the lives of all Americans.
African Americans have nearly twice the occurrence of others for low birth weight babies, fetal deaths, and infant deaths. Infants that die in the first 27 days of life occur at a rate of three times that of whites. And also according to the Center for Health Disparities at the University of Northern Iowa, African Americans have a higher rate of diabetes than other populations. But whatever the disease or injury is, in almost all cases, African Americans suffer higher mortality and morbidity rates than any other group. But why is that?
The simplest explanation is that many of the issues that prevent African Americans access to health care are the same financial ones that keep people of all races out of the health care system. However the problem looks even worse for Black Iowans as a group. On average, African Americans earn nearly 40% less than whites, and are four times as likely to live below the poverty level. Compounding the problem, around 70% of African American families in poverty have a single woman as the head of the household, and in the absence of another partner to help shoulder the financial and familial load, she must perform the delicate balancing act of taking care of her family while determining which bills get paid, and this is not always an easy choice. Lack of insurance coverage, lack of transportation, limited hourly access to clinics, and a general lack of knowledge of the health care system all contribute to this problem of access.
Because of this limited access, African Americans are also less likely to seek treatment for major health problems in a timely manner, and will often wait until the problems become more severe and complicated to treat. If we are truly serious about achieving cost savings by getting people better up-front and preventative care, this is an issue that will have to be addressed in any significant health care reform, either at the state or federal levels.
The historical legacy of racism, illegal and legal segregation, unethical scientific experiments, and other abuses have made many African Americans distrust our health care system. The Tuskegee Experiment debacle may seem like ancient history to many Iowans, but such histories are still fresh in a lot of minds and are passed down from generation to generation with real meaning to many in our community. It should be no surprise that the two populations that have the worst health status in America, Native Americans and African Americans, also are the two populations that have suffered the worst mistreatment by the majority population.
Before we can find a solution, we must correctly identify the problem. Before we can turn the page on history, we must read what’s on that page. And the reality of race-based disparities in health care in America is a story that many people do not know. And problems that face African Americans and other minorities in gaining access to the best quality health care are multiple and complex. Real equality of opportunity for all people requires that we reform our state and national health care systems to focus not only on coverage, but this reform must also focus on the severe racial discrepancies in health care quality, cost and access that arise from what are known as the “social determinants of health,” such as income, education, social and physical environments.
So where should we go from here? With 47 million uninsured in America, this is the civil rights cause of our time. Get involved, write letters, make calls to your elected officials, and organize others, because this is a fight that will take the collective energies of all of our communities – urban, rural, black, brown, and white – to win.
Abraham L. Funchess, Jr. was appointed by Governor Tom Vilsack to serve as Division Administrator of the Iowa Commission on the Status of African Americans within the Department of Human Rights. Funchess was reappointed to the position by current Governor Chester J. Culver. In 2003, Funchess was appointed by Resident Bishop Gregory V. Palmer to serve in the Iowa Annual Conference to work at Jubilee United Methodist Church in Waterloo, where he still serves.
Dr. Alta Price will return next Tuesday with her weekly Health Care Reform Update