“A nation that continues year after year to spend more money on military defense than on programs of social uplift is approaching spiritual doom.”
So spoke Martin Luther King, Jr. on April 4, 1967 — one year before his assassination.
 
In this week that’s sure to be inspirational and aspirational, I ponder Dr. King and the state of health care in America.
 
Health disparities continue to mar the State of American Health Care. “Race remains a significant factor in determining whether an individual receives care, whether an individual receives high quality care, and in determining health outcomes,” according to the Kaiser Family Foundation.
 
The Kaiser Family Foundation (KFF) published a report in the context of health care in the 2008 elections in October 2008 titled Eliminating Racial/Ethnic Disparities in Health Care: What Are the Options? Some of the key facts that KFF notes to paint the problem of disparities include:
  • The infant mortality rate for college educated Black women is higher than that for White women with similar education — 11.5 vs. 4.2 per 1,000 live births.
  • The rate of new AIDS cases in 2003 was 3x higher among Hispanics and 10 times higher among African Americans than among Whites (26 and 75 per 100,000 vs. 7 per 100,000).
  • At least 1 in 3 non-elderly Latinos (36%) and 22% African Americans are uninsured, compared with 13% of Whites.
  • Black and Latino adults are less likely to rely on a private physician for their medical care than White adults (62% and 44% vs. 77%).
  • African American children have a rate of hospitalization for asthma that is 4 to 5 times higher than the rate for White children (527 per 100,000 vs. 144 per 100,000).

Health Populi’s Hot Points: This short list of disparities represents just a handful of the countless differences that happen in health care delivery every day to thousands of people seeking medical care in the U.S. This small inventory suggests several basic strategies that could get to the root of excising disparities in American health care:

  • Expand health coverage because people without insurance tend not to have a regular source of care. Minority Americans are much less likely to have employer-based health insurance than White Americans.
  • Make the primary care medical home a focus of care in America so that citizens have a first place to go for care. This can help people navigate the complex maze of care in the U.S.
  • Environmental and other non-health system factors drive health status. Look at the epidemic of asthma among African American kids. Health is derived from more than health care services; it’s about whole health, 24×7. Information needs to get out to communities at risk about environmental factors, nutrition, and other ‘inputs’ into whole health. Most public health information is pretty homogeneous and isn’t always personally relevant for the people who really need it.

Fundamental health reform that speaks to access, health literacy and cultural competency can reduce racial disparities in health. By doing so, we’ll move toward the kind of social uplift about which Dr. King spoke.

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