Six Years Later, Health Disparities by Race and Ethnicity Persist

The Lancet provides one New Yorker's story:

James
North, a 50-year-old African-American, had borderline cardiac function
but had been admitted to hospital only once when he went to see Neil
Calman in the Bronx, New York City.

Mr
North meticulously recited the medications he was taking and explained
how he controlled his congestive heart failure by monitoring his weight
and adjusting his diuretics.

“I
could not provide Mr North with all that New York's great health-care
institutions had to offer. He knew that. He often tried to teach me
that and was just as often amazed that I was unable to accept it”,
wrote Calman in the Bronx Health REACH Coalition newsletter in autumn
last year.

Mr
North's case provides a vivid illustration of the inequalities in
health care received by minorities in the USA. His cardiologist never
thought of referring him to a heart-transplant centre and it took three
separate interventions from Calman to get him a consultation. The
echocardiography lab sent him home after Mr North was 10 minutes late
because he had to keep stopping to rest on his walk there on a windy
day. The pharmacy refused to refill his insulin syringes without a
written prescription, even though he had been going to the same place
for 2 years.

As
the article points out, these differences in the type and quality of
care received cannot be explained away by differences in insurance
coverage or socioeconomic factors, such as levels of education or
income.  Perhaps emphasizing that Mr. North is not alone in his
experiences,

A New York State Department of Health study found that although
African-Americans have the highest rate of hypertension and
cardiovascular disease, the use of diagnostic testing, such as cardiac
echocardiography, was very low for them. Sophisticated treatment, such
as bypass surgery, was also administered less often in comparison with
white people.

Similarly,
a report authored by The Opportunity Agenda and over 30 other
organizations and scholars, submitted earlier this year to the U.N.
Committee
on the Elimination of Racial Discrimination, Unequal Health Outcomes in the United States found the following with regards to racial and ethnic disparities in American health and health care:

• The 2006 National Healthcare Disparities Report found that,
  across a range of measures of health care access, Latinos received
  equivalent care as whites in only 17% of the measures, and that access
  to care had worsened from previous years for Latinos on 80% of the
  study measures.
• From 1999 to 2004, the proportion of white senior adults (over 65)
  who did not receive a pneumonia vaccine dropped from 48% to 41%, but
  for Asian American seniors rose from 59% to 65%.
• Insured African American patients are less likely than insured
  whites to receive many potentially life-saving or life-extending
  procedures, particularly high tech care, such as cardiac
  catheterization, bypass graft surgery, or kidney transplant.
• People of color are more likely to receive undesirable treatment than whites, such as limb amputation for diabetes.
• And even in routine care there are disparities.  Black and Latino
  patients are less likely than whites to receive aspirin upon discharge
  following a heart attack, to receive appropriate care for pneumonia,
  and to have pain--such as the kind resulting from broken
  bones--appropriately treated.

As stated in The Opportunity Agenda's report on health care in New York City, Dangerous and Unlawful,
a health care system that is "too expensive, too far away, too
inconvenient for working families, too insensitive to our language
needs and cultural differences -- in short, too far out of reach for
too many" is a dangerous system that is costly to all Americans,
contributing to skyrocketing costs and diminishing our quality of
life.  More importantly, however, a system that is inequitable, where
the language you speak or your appearance may determine whether you
receive potentially live-saving care, is one that violates our values
of equality and community, and builds unlawful barriers to accessing the shared American dream of opportunity.