Need for Education, Behavior Changes Cited : Minorities Suffer From Health Gap

Health and Human Services Secretary Margaret M. Heckler Wednesday attributed the huge disparity between the health of minorities and that of whites to knowledge and life style and said that the gap could be significantly reduced through more education and changes in personal behavior.

“Education is perhaps the most important single thing we can do to close the health gap,” she said at a press conference at which she released a 21-month federal study. “Progress depends more on education and a change in personal behavior than it does on more doctors, more hospitals or more technology.”

The secretary, acknowledging that “this is an environment in which new programs are not particularly encouraged,” nevertheless insisted that increased government funding would not solve the problem. “This is a problem as old as our whole experience,” she said. “Even if we had a blank check, this disparity would not change. Money alone has not resolved it in the past.”

60,000 ‘Excess Deaths’

She said that a federal task force, appointed in January, 1984, to determine why these health inequities exist, found that the disparity translates into nearly 60,000 “excess deaths” annually, defined as deaths that would not have occurred had mortality rates for minorities been as low as for whites.

The panel, saying that “the ability to make informed decisions plays a significant role in influencing the overall health status of Americans,” urged the department to launch a major campaign to disseminate health information specifically designed for minorities.

It also recommended that the department initiate discussions with health professional organizations, academic institutions, state health departments, community agencies and other organizations outside the federal sector to “develop strategies to improve the availability and accessibility of health professionals to minority communities.”

New Office Planned

Heckler said her department would establish a new office, under the direction of Dr. James Mason, acting assistant secretary for health, to implement the committee’s recommendations and monitor the department’s $3-million budget to ensure that attention is paid to minority health problems.

Heckler called smoking, alcohol consumption, diet and obesity “clearly linked to the higher cancer, cirrhosis, cardiovascular, infant mortality and other disease rates afflicting minorities” and said that “knowledge about the symptoms of disease can lead to early detection, early treatment and fewer deaths.”

The Children’s Defense Fund, a public advocacy group, criticized the study as “hypocritical” and “cruel” for ignoring poverty and the Reagan Administration’s own funding reductions in programs for the poor.

“There is no question that if we lived a cleaner life we’d be better off, but some of us just can’t afford eating fresh fruit, vegetables and more fish,” said Sarah Rosenbaum, director of the group’s health division.

Six Areas of Concern

The report identified six health areas accounting for more than 80% of the total disparity, including cancer, cardiovascular disease and stroke, chemical dependency as measured by deaths caused by cirrhosis, diabetes, homicides and accidents, and infant mortality.

Heckler described homicide, which the report called the leading cause of death for black males aged 15 through 44, as “more than just a social problem and a criminal justice problem” but “a public health problem as well.”

She suggested that health education in schools include “teaching children to manage hostility and aggression” and that public education measures help parents learn effective discipline and how to “avoid excessive punishment.” She also called for improved record-keeping in hospital emergency rooms to help identify victims at high risk.

Heckler described the cancer death disparity as “serious” and said that, in some areas, it appears to be increasing.

Lung Cancer 45% Higher

“Lung cancer is 45% higher, cancer of the esophagus is three times higher, stomach cancer is 1 1/2 times higher, prostate cancer is twice as high and cervical cancer is 2 1/2 times higher,” she said.

She said that alcohol-related illness among blacks, as measured by cirrhosis and esophagus cancer mortality rates, exceeds that for whites, despite higher per capita alcohol consumption rates among whites.

Statistics for cardiovascular disease, the No. 1 killer of all Americans, reflected a greater death rate for blacks compared with whites, but an apparent lower overall death rate for native Americans, Asians and Pacific Islanders, she said. However, native American males under age 45 die of heart disease at a greater rate than whites, she said.

DEATH RATES Average annual age-adjusted death rates per 100,000 population for all causes. 1979-1981

MALES White 736.0 Black 1084.6 Native American 740.0 Asian/Pacific Islander 449.8 FEMALES White 405.0 Black 611.7 Native American 408.1 Asian/Pacific Islander 244.4