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John Whyte, M.D., MPH

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The Health Challenges in the Black Community

Posted: 02/20/11 11:19 AM ET

Most people know it is Black History Month and there is certainly a great deal to celebrate. Black people have made significant advances socioeconomically as well as politically -- especially in the last few years. However, in the field of health, there's not a lot to celebrate.

If you're black, you're going to die sooner than your white counterparts and you're going to suffer from more serious diseases. For example, cancer deaths may be decreasing in the United States as a whole but black people still bear the burden of cancer deaths. The American Cancer Society's latest data show that cancer deaths among black men are 32 percent higher than white men; black women's rate of death from cancer is 16 percent higher than white women. Worse, when black people are diagnosed with cancer, it's often at a later stage when there are fewer treatment options and the ones that we have are less effective.

If you have arthritis and you're black, guess what? You're probably not getting the best care. In recently released data, researchers found that black men were less likely to be treated with the drugs that are recommended as effective therapy. As a result, they are getting substandard care and needlessly suffering.

In the classic case of "glass is half full", look at how stroke is handled. Black people have a higher risk of having a stroke, but if they do, they more likely survive than whites do. Is this a good thing? I'm not sure. This may actually be despite what medicine does, because black people actually receive clot-busting drugs (the standard treatment) less often than whites. And the focus needs to be shifted to preventing this debilitating disease.

Nowhere is the disparity greater than in the area of HIV. This year marks the 30th anniversary of the first report of HIV. Within those 30 years, we have made tremendous advances in helping to reduce the incidence of HIV, as well as changing it from a death sentence to a disease you can live with. Unless of course, you're Black. Black people comprise 13 percent of the population yet they account for over half of all HIV diagnoses. The rate for HIV diagnoses for black men is eight times that of white men, and the rate for black women.

Why do we have these tremendous disparities? There are multiple reasons. These include less access to health care, lower quality hospitals and medical personnel in areas where black people live, bias in the health care system, as well as some distrust of the medical community. Many older black people still remember Tuskegee where government doctors intentionally infected black men with syphilis and did not treat them to see how the disease progressed. If you grew up during that time, I'm not surprised you don't have a good view of the medical community.

So how do we work to eliminate the differences? Certainly, I think it is important to encourage more minorities to enter the health professions, especially medicine. We don't always do a good job of being culturally sensitive. And I'm not suggesting you need to be treated by a doctor of the same race as you, but for some people it can make a difference and increase your comfort level. I also think it is important that we don't always feel it needs to be the doctor's office where we deliver information on prevention.

A study released by the University of Michigan earlier this month found that a majority of black men avoid physician visits because they find the interaction stressful. The survey participants remarked that physicians typically did not give useful information on how to make lifestyle changes. So let's consider other options. For examples, churches and even barbershops have been areas in the black community where effective health messages have been delivered, especially as it relates to areas like prostate cancer screening.

So let's indeed celebrate Black History month. But let's also be aware of the need for progress in the health of black Americans so in future years, we can celebrate not only socioeconomic and political advances, but also health advances.

 
 
 
Most people know it is Black History Month and there is certainly a great deal to celebrate. Black people have made significant advances socioeconomically as well as politically -- especially in the l...
Most people know it is Black History Month and there is certainly a great deal to celebrate. Black people have made significant advances socioeconomically as well as politically -- especially in the l...
 
 
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11:09 PM on 03/15/2011
The stats are alarming but true, black communities are suffering from lack of education on health, fitness, nutrition, and financial literacy. Many suffer from diabetes and obesity and continue to eat poorly and neglect their health. As a health and financial literacy advocate for urban communities it pains my heart to witness the amount of ignorance and acceptance that exist despite the opportunities that are presented. The question is how do we begin to transform communities that are miles behind in education across the board?
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Dolphinfan65
The Revolution is happening NOW!!
07:12 PM on 02/21/2011
NO money NO services< simple as that. As far as what do well paid African American do, when they get sick that simple too!!. Most go to a doctor, but there are a few who don't trust Doctors, and will not go unless they are near deaths door, and it's generational too. So the older you are the more you don't SEEM to trust doctors.
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lezahgg
11:16 AM on 02/21/2011
Just an observation--I work for a company that provides excellent insurance benefits and pays decent salaries. Our co-pays are not outrageous nor is our deductible. At least half my colleagues are African American and I am always surprised by the number of my colleagues (all college educated people) who don't have primary physicians and use emergency rooms as their source for primary care, and often when they do see doctors, don't fill prescriptions. When we do discuss these things I learned that a lot of my colleagues just don't trust doctors, medicine, etc.
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iRock
and that's all that needs to be said...
10:21 PM on 02/20/2011
That's why it's imperative that black americans, myself included, take PREVENTATIVE measures in regards to health care. Get healthy. Stay healthy.

I am lucky to have good health care, but my job as a healthy young adult is to get my body to optimal health and keep it that way. Unfortunately, culturally, black americans don't have the healthiest diets generally speaking. A lot goes into what's available/convenient, but there has to be a change at the family/community level to see real change. As is anything in any community for any problem.

For now, I can only take care of me and hope others are inspired my the changes I've made. If they're not, at least I'm healthy!

Life.
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blitznstitch
BAZINGA!!!
09:27 PM on 02/20/2011
Main reason is not having access to health care because it is too expensive.
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08:51 PM on 02/20/2011
None of this is news. In the Black community, the Latino community, poor white communities, there will be the inevitable disparity in health care, as well as access to decent produce, supermarkets, decent education, clean water. Poverty and the fact that we are decades behind the rest of the world in adopting a kind of health care system that is effective, less expensive than what we currently suffer with, and available to everyone. We need MORE than just health reform, we NEED to finally catch up with the rest of the free world and have SINGLE PAYER care for everyone.
05:30 AM on 02/23/2011
Like in Canada… http://www.windsorstar.com/Tight+security+upsets+family+dying+baby/4329923/story.html

These may be extreme cases and few and far between, but I DO NOT WANT the government deciding the best course of health for myself or anyone in my family.
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Chas53
08:02 PM on 02/20/2011
Fast food abounds in the Black Community.
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iRock
and that's all that needs to be said...
10:23 PM on 02/20/2011
Black communities have to stop going to get them out. Until then, McDonalds is still going to have their little 'hip hop' commercials marketing to the black folks.
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alongst
too often denied to speak
06:27 PM on 02/20/2011
No where have you mentioned personal responsibility or even the fact that there are increasing numbers of non-white male doctors out there.
I find noncompliance to be the biggest problem with patients- many will not take their medications or restrict their diets or even check their blood sugar. A lot of them are very passive aggressive in that they want the doctor to do everything for them, and that they should have no responsibility at all
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Case in point- I had one fellow bring in his wife for terrible sores on her feet from her poorly controlled diabetes. I showed him how to do proper wound care , check her glucose levels and put her on antibiotics and told them to see her doctor next week. A month later, they show back up in the ER and her feet were much worse. It was obvious he had done none of what we asked him to do and his response was " Well, ya'll need to do it because I'm not touching her feet- they're nasty ! Someone needs to do something about them !".
Personal responsibility.
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iRock
and that's all that needs to be said...
10:24 PM on 02/20/2011
personal responsibility for one's health is the biggest and first step!
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Havana Thinks
Live and Let Live!
01:20 AM on 02/21/2011
I hope your post was honest and not for entertainment, alongst. Are you AA? Do you understand how to talk to AA men without blaming them? I would suggest that you could have personally asked the man for the phone # of their church where there would have been many opportunities to give the woman assistance by her 'sisters'. I can think of more opportunities for you to have come up with a solution but you seem to only cast aspersions on the AA male.

Might want to improve your bedside manner. Different races, cultures react differently.

I do realize you did not state the race or color of the "fellow" but I am concluding from the context and the topic being AA's not receiving the care that white folk receive in health care, he was AA.
05:36 AM on 02/23/2011
What does it matter about their race.

A doctor gives you medical advice…
You don't follow it…
YOU accept the consequences!

If a doctor is mean to me, I might be upset or angry but I will still follow what he says. And her "sisters" need to help her, its the mans wife for crying out loud. Man up and help your WIFE! That crosses all racial barriers!
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Colin Daniel
06:12 PM on 02/20/2011
As a black when I lived in Canada I two experiences with the medical system that left me stunned. In the first instance it was the day Princess Diana died, I was in Canada on vacation at the time. I had what was most likely an anxiety attack and with elevated blood pressure. I was hyperventilating and having difficulty breathing. On admission to the ER I got the distinct impression that as far as the doctor was concerned I was more than likely high on something and he proceeded along those lines in his investigation.

The second instance happened when I lived in Canada, leaving work with blurred vision and hyperventilating again. This time I when to my GP's office and unfortunately my regular doctor was not there. The doctor I saw was uninterested in what was going on and implied that I just wanted time off from work.

What was discovered a few months later I was suffering from untreated sleep apnea. I had a history of hypertension which neither doctor attempted to address during either visit.

The best treatment I had was when I lived in Bermuda and my GP was a white South African - his prompt intervention helped me prepared for what turned out to be my most serious health challenge when I lived in the Cayman Islands.

Doctors need to listen to their patients and understand that they know their bodies better than anyone else.
05:37 AM on 02/23/2011
They do when they work for the patient not the government!
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lynjs
Take each day as it comes. Tomorrow isn't promise
06:05 PM on 02/20/2011
The reason for the disparities in healthcare within the African-American community can be summed up in two words: CARING; or the lack thereof and money.

There are still doctors and healthcare professionals that still don't care when it comes to the health of African-Americans. They either want a boat load of money UP FRONT something that most don't have or they act like you don't have the right to see the doctor. The latter comes from some of the office workers. They act like they're judge and jury over you and the doctor doesn't even know the office politics that are going on.

In 2008, I was diagnosed with a chronic gallbladder that needed to come out on February 5. It was 20 days later and two trips to the ER before the surgery was done because the surgeon had to go on vacation...yeah...vacation.

To this day, I still have some nausea on a regular basis. I feel the that the main reason was not per se race, but money. I didn't and still don't have health insurance.

And those clinics that are setup for the poor, just do simple care, at least here they do. They may send you for tests, but that is another bill. And some won't send you when they find out you're broke. So there you have it.

It is a sad commentary when race and economics trump one's health in the richest country in the world.
05:55 PM on 02/20/2011
"If you're black, you're going to die sooner than your white counterparts and you're going to suffer from more serious diseases."

This is not true at all.

I think it's careless to make such an absolute statement. There are black people who live to be over 100, and may have outlived some of their white counterparts.

Disease and illness do not seek people out by race. Economics is a huge factor and contrary to popular belief, black and poor are not synonymous.
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iRock
and that's all that needs to be said...
10:25 PM on 02/20/2011
well said.

And just because you are economically 'disadvantaged' doesn't not mean you have to succumb to bad health.
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Judster
06:53 PM on 02/21/2011
I believe that the writer meant, on average black people died sooner and he provided the statistics and research to substantiate his claim.

I think that the diet of poor Americans, regardless of race, is poor and that is reflected in their food choices. It is expensive to purchase organic foods, and the uneducated are unaware of the benefits of a healthy diet, exercise and preventative care. As with most of the conditions that ail us as a society, it all starts with education.
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urnumbersix
"I am not a Number. I am a Free Man!"
05:52 PM on 02/20/2011
Important article.
But Big points missed here.

1) The future of fields of medical treatment, diagnosis and pharmaceuticals are becoming more and more based on the genetic code. "Personalized Medicine." But the fact is that clinical trials to Develop these miracles tend to be comprised of White Males.

Therefore, these new Medical Miracles could well be contraindicated for all women and racial and ethnic minorities. And by 2020, MOST OF AMERICA will be racial and ethnic minorities.

Companies that develop new technology merely follow the profits. It will take Government Intervention to ensure that the "baseline" of these new miracles can Actually serve the American population. We are wasting big money and lots of lives if we don't get this right.

2) Although mentioned, it was not made Clear that people in clusters of a preponderance of different genetic backgrounds Respond to treatment and Present disease in very different manners to various treatments and diagnoses.

Therefore, given that we Know this -- the efforts made by the medical community to "treat all their patients the same" is actually Malpractice! Health care professionals need to learn and APPLY this knowledge of differences.

Yes, the variables and permutations are immense, but computerized electronic records and other data programs can assist professionals to ACTUALLY provide the Appropriate care to Each patient.

As you can guess, I could go on - but will stop here for now.... LOL!
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alongst
too often denied to speak
06:17 PM on 02/20/2011
I love when nonmedical people try to tell me how we need to practice medicine and chant that electronic records is the cure all.
I would laugh but it's too scarey !
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urnumbersix
"I am not a Number. I am a Free Man!"
07:13 PM on 02/20/2011
And You Assume that I am non-medical.

You could Not be more wrong....

Try reading & keeping up on things Beyond what is Required for Board....
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dlo2
11:22 PM on 02/20/2011
Once pharmacogenomics advances (when the recession is in our rear view mirror and federal funds are available for research) and the FDA increases black box warnings on pharmaceuticals known to have genetic risks, I think that genomics will be a front and center issue. In several countries, genetic tests are available and, within a decade or two, hopefully we can make use of our knowledge and electronic record information will pop up when providers write prescriptions (as well as addressing the complexities inherent in polypharmacy). Iatrogenesis is a sobering and enormously expensive issue and one that perhaps pharmacogenomics might one day remedy. The human genome was mapped in 2000 and many scientists say that it will take 30 years in basic science to realize the potentials of this amazing feat.
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04:09 PM on 02/20/2011
I'm not African American but I am a part of a racial minority that is "at-risk" for several serious health conditions like heart disease, hypertension, and diabetes. As a single man I can identify with the fact that I already have a lot of stress in my life, and most of us guys don't really have a support network where we can openly talk about health issues. Seeing the doctor can only bring on more stress, even though I know it's better to catch potential problems early. Friends have told me that within the African American community, the church is the key venue to deal with serious personal issues- but that it can be too judgmental about lifestyle decisions that have already been made. I think things like meditation and spiritual yoga might be the key to reducing the stress, which could lead to better health.
03:59 PM on 02/20/2011
its called the darwin principle
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dlo2
03:44 PM on 02/20/2011
I worked on a study of called the "Underutilization of Cardiac Procedures" that studied the disparity of health care in cardiology. Whether it is opioid use disparities in long bone fractures or the care of sickle cell in ERs, the issue is prescient and critical to health and justice.

On another issue: Many physician groups are urging Republicans in Congress to stop dragging their feet on health care legislation and its funding: https://www.acponline.org/advocacy/events/state_of_healthcare/doherty11.htm
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alongst
too often denied to speak
06:20 PM on 02/20/2011
Sorry, but for a very few academic physicians, most are very much against Obamacare.
Most of us trained at one time in a government run hospital and have seen what government run healthcare is really like and how bad it is ( think VA hospitals, where even congressmen are not safe).
The vast majority of doctors are Republicans- we worked too hard to get where we are to be liberals.
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maybealittlecommonsense
kick it root down
06:52 PM on 02/20/2011
You mean single payer wouldn't be heaven on earth? The libs have been lying to us?
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mikey09
Living off the grid.
06:54 PM on 02/20/2011
In my area we have a Primary care doctor shortage. And most of these Doctors have stopped taking medicaid patients and are limiting the number of medicare patients. Some think its all abt money...but I think its the result of the doctor shortage, some doctors are seeing 60-70 patients a day and simply can't take on more....and I'm sure the slow, low reimbursement from the government does not help matters, I fear HCR will make these problems worse.