For blacks, poor healthcare access can cost lives
More than 886,000 deaths could have been prevented from 1991 to 2000 if African Americans had received the same care as whites, according to an analysis in the December issue of the American Journal of Public Health. The study estimates that technological improvements in medicine -- including better drugs, devices and procedures -- averted only 176,633 deaths during the same period.
That means “five times as many lives can be saved by correcting the disparities [in care between whites and blacks] than in developing new treatments,” Steven H. Woolf, lead author and director of research at Virginia Commonwealth University’s Department of Family Medicine, said in a telephone interview.
Woolf and four coauthors compiled and examined the data, which they drew from the National Center for Health Statistics.
“We were trying to say that there was something you could do in medical research to improve health outcomes,” said coauthor David Satcher, former U.S. surgeon general and current director of the National Center for Primary Care at the Morehouse School of Medicine. “But if you didn’t focus more on the translation of that into especially the populations that tended to be left behind ... you were not going to get as much out of the research as you would otherwise.”
Dr. Otis W. Brawley, medical director of the Georgia Cancer Center for Excellence and professor of hematology, oncology and epidemiology at Emory University in Atlanta, said, “It’s important [to note] that this is not an argument against science.... This is an argument that there are therapies out there that are not new that people just don’t get.”
Reduced access to healthcare doesn’t account for all the racial disparity in preventable deaths. Blacks have greater incidence of some diseases; some of this greater morbidity results from education, income level and environment as well as access to healthcare. The challenge, the authors said, is to deliver the same quality healthcare to everyone, despite these factors.
One of the goals of Healthy People 2010 -- the nation’s health priorities for the decade -- is to eliminate such inequities in healthcare. Satcher said some steps, such as the creation of the National Center on Minority Health and Health Disparities at the National Institutes of Health, had already been taken, but more needs to be done.
“Access to care is a big factor. African Americans and Hispanics are much more likely to be uninsured and underinsured and underserved” and may not seek care as often as whites, Satcher said. “So a great part of it is really focusing on how do we get prevention programs, intervention programs [and] treatment programs to people in underserved communities?”
