Racial divide widening in public health care

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Despite having an African-American president, discrimination persists in the United States. And the racial divide seems to be widest in the public health care system.

“Most people of all racial and ethnic groups out there are unaware that disparities in health even exist. If they don’t see the disparities…why do something to mobilize the use of something to solve the problem if you don’t even know the problem exists?” said David Williams during the Q&A portion of the discussion. “First of all, we need to figure out ways to raise awareness levels and secondly, we need to figure out ways to effectively communicate.”

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DAVID WILLIAMS

The panel discussion, “Minority Health: The Social Factors That Determine Health Disparities,” led by Harvard University professor of African and African-American Studies, David Williams, and Washington University in St. Louis professor of Racial and Ethnic Diversity, Sarah Gehlert, was part of a weekend-long national conference held on the University of Pittsburgh campus in the University Club from June 3-6. The conference, “Race in America: Restructuring Inequality,” was hosted by Pitt’s School of Social Work and Center on Race and Social Problems.

Gehlert discussed how factors such as low income, social isolation and, particularly, stress contribute to the high incidence of breast cancer and the high mortality rate among low income African-American women in the U.S. Gehlert’s theory that stress, depression and poor living conditions played as large a part in the disparity between the mortality rates of African-American women and White women as did hormones and other genetic factors was supported by a study done with rats. In the study, rats that were isolated from the group tended to develop larger, more aggressive tumors than those that were permitted to socialize with other rats. The same held true for African-American women who lived in low income neighborhoods who felt isolated from others.

“Society manipulates the living conditions of women to cause large mammary tumors in the same way that [Martha] McClintock [who conducted the study with Gretchen Hermes] manipulated the living conditions of rats in her study,” explained Gehlert in her speech.

Positive results, in terms of lowering mortality rates, occurred when women on the South Side of Chicago—where Gehlert tested her theory regarding the correlation between social conditions and breast cancer—received interventions like membership in programs like the Sister’s Network, psychotherapy or participated in patient navigator programs. “Multi-level interventions were more helpful than one,” said Gehlert. “Developing social networks in communities is helpful.”

But it’s not only African-American women who are suffering and dying at higher rates than their White contemporaries. According Williams, minorities in general, and African-Americans and American Indians in particular, get sicker, experience illnesses more severely and have higher death rates on average than their White countrymen. Again, socio-economic status was considered a key factor in the disparities between minorities and Whites, in addition to genetic factors.

Racism, especially internalized racism, and segregation have an enormous impact on the quality of care that minorities are able to receive because “segregation limits access to health care,” Williams said. “Racism affects health by increasing stress.”

As an example, Williams discussed the ill-effects suffered by Arab-American women because of the negative treatment they received in the aftermath of the terrorist attacks on Sep. 11, 2001. Within six months, Arab-American women began delivering more low birth weight babies and had more premature births than they had before the 9/11 attacks; and this increase only occurred among Arab-American women during that period.

The fact that African-Americans tend to live in low income neighborhoods and are less educated than Whites also contributes to the overall poor health of their communities.

“Moving people from bad neighborhoods to better neighborhoods improves health,” said Williams. “Improved income, improved education leads to improved health and decreased disparity between races.”

Religion, too, is a powerful resource to help reduce stress and improve overall health; however, “religion is not a panacea,” said Williams. “It can also have negative effects.” Besides the fact that religion can be used to make people feel that they are being punished by God, Williams offered as another example, a study that determined that there is a direct correlation between increased obesity among African-Americans and regular church attendance. Williams referred to it as the “pot-luck effect.”

Lester Bennett, a graduate student, majoring in rehabilitation counseling, has to deal with discrimination on a duel level because besides being African-American, he’s also paralyzed from the waist down, the result of a gunshot wound he received when he was 19. He attended the conference primarily because he will be writing a paper on health disparities faced by African-Americans with disabilities. “There’s a lot more that can be done,” he said, “to bring these issues to the attention of people who, like me, have to live with them every day.”

Increased awareness, improved socio-economic status and increased education are just three ways that African-Americans can finally begin to see an end to health disparities between themselves and their White counterparts.

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