Healthcare gap persists for minority women

Minority and low-income women in Los Angeles County are more likely to have limited access to healthcare and to struggle with chronic diseases, according to a new report by the county Department of Public Health.

The report, "Health Indicators for Women in Los Angeles County," was released last week by the Office of Women's Health and the Office of Health Assessment & Epidemiology.

Among the findings:

* African American women were far more likely to suffer from sexually transmitted diseases, including AIDS, and to die from chronic illnesses. For example, although white women had a higher incidence of breast cancer, African American women were more likely to die from the disease.

* Latinas reported the poorest health status of women in all ethnic groups, with disproportionately higher death rates from diabetes. Their obesity rate increased from 27% in 2005 to 31% in 2007 and they reported less access to healthcare, with more than a third lacking health insurance and about 41% reporting difficulty accessing care.

* Asian women reported lower rates of preventive healthcare; they were the least likely of any ethnic group to have had a Pap test in the last three years or a mammogram in the last two years.

* Of uninsured women, 54% had a mammogram in the last two years compared with 68% of women with Medi-Cal and 79% of women with private insurance.

* Obesity rates among women went up countywide since 2005, with the largest increases in the South area that includes South Los Angeles, where the rate went from 33% to 41%, and in the San Gabriel area, where the rate rose from 17% to 22%.

"One of the most important or startling findings is the fact that African American women continue to have the greatest health disparities and have far higher mortality rates than other women," said Dr. Rita Singhal, who helped write the report. African American women may be suffering higher mortality rates because of unhealthy behaviors, the report says.

Their smoking rates were two times higher (20%) than the county average for women. About 34% reported that they were obese -- more than twice the percentage reported by white women -- and about 46% reported being minimally active or inactive.

They were nearly twice as likely as white or Latina women to have had sex without a condom during the last year.

"Those are certainly factors, but it doesn't explain it completely," Singhal said of the higher mortality rate.

Singhal said researchers suspect African American women and Latinas may suffer racial inequality, discrimination and stress in trying to maintain healthful diets and access quality healthcare.

"We need to work collectively to improve women's health and reduce disparities not just for African Americans but for all women," said Dr. Jonathan E. Fielding, the county's public health director.

Lark Galloway-Gilliam, executive director of Community Health Councils, a nonprofit health advocacy group based in South L.A., noted that in recent weeks, the governor restricted access to a free breast cancer screening program at sites, including Harbor-UCLA Medical Center, that serve many low-income minority women.

"We have to look at the role of public policy in dictating the access to care and the ability for people to stay healthy," Galloway-Gilliam said.

The report was based on data from the Los Angeles County Cancer Surveillance Program, the UCLA Center for Health Policy Research, the California Quality of Life Survey and the 2007 Los Angeles County Health Survey of 7,200 adults, about half of them women.

molly.hennessy-fiske @latimes.com

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