Reflecting on Unacceptable Health Disparities During Black History Month

There is a lot to recognize during Black History Month. But when it comes to health care, there is little to celebrate.

 

Secretary of Defense Lloyd Austin’s recent encounter with prostate cancer reminded people that Black males have a higher incident of prostate cancer than Whites. Less often mentioned was the fact that African American men diagnosed with early-stage prostate cancer were less likely than White men to receive any type of treatment for that cancer and that Black men die from prostate cancer at over twice the rate of White males.

 

This disparity in diagnosis and care is not unique, but it is unacceptable. Almost anywhere you look in the health care statistics, there are disparities in the rates at which Blacks are diagnosed, disparities in the way they are treated, and disparities in the outcomes—all to their disadvantage.

 

The numbers are consistent and discouraging. Black children have asthma at almost twice the rate of their White peers. Forty-two percent of Blacks suffer from hypertension, versus 29 percent in the White population. Blacks have the highest mortality rate from all cancers of any racial or ethnic group in the U.S. Infant mortality it twice as high among Blacks. During the pandemic, Black Americans had a Covid-19 mortality rate that was 2.5 times higher than White Americans, and they were three times as likely as to become infected. One poll conducted by The Washington Post in 2020 found that 31 percent Black Americans said they had known someone who had died of Covid-19, but only 9 percent of White Americans said the same.

 

The problem of health care disparities is complex, and particularly deserving of our attention during Black History Month, because the problem has deep historical roots that need to be addressed if the gap is to be closed. Systemic racism is a factor. The failure to adequately increase the number of Black nurses and physicians is a factor. Mistrust of the health care system based on historical mistreatment is a factor—in the 40-year-long Tuskegee Syphilis Study, a portion of the men in the study were deliberately left untreated but not told what they had or that they were not being treated. More than two dozen of them died.

 

We must also see and address the social and political determinants of health. These are the non-medical factors that have an impact on health care outcomes. They include socioeconomic, educational, employment, housing, and environmental factors that are rooted in systemic racism, and biases in the political system that lead to inequitable uses of fiscal and human resources to the disadvantage of people of color. There are a lot of barriers to health care equity that need to be removed.

 

There is an urgent, compelling need to address the equity issue at every level. It begins here, with who and how we educate the next generation of nurses, including the many who will provide primary care and will have the ability to prevent disease and promote wellness. It means addressing the social and political determinants that create barriers to health care access. And it means identifying and addressing implicit bias that results in unequal treatment when there is access to care. 

 

I encourage everyone to take advantage of two excellent opportunities at YSN to hear from two knowledgeable experts during Black History Month:

 

At 3:30 p.m. on February 8 in room 11701, Dr. Daniel Dawes will discuss and sign copies of his landmark book, “The Political Determinants of Health.” A reception will follow at 5 p.m. in the Hub. Everyone is invited and encouraged to attend. Dawes is a renowned expert on health care issues and his book has been widely acclaimed for its insights into root causes of health care disparities.  Register here. 

 

At 4 p.m. on February 27, Associate Dean for Equity Dr. Angela Richard-Eaglin will present the second part of a community discussion on critical events that led to the civil rights movement and the issues that continue contributing to inequality. In this second gathering, input is sought from the YSN Community about actionable solutions to meet the challenges and create outcomes that affect both the YSN community and the community at large. The discussion will take place in room 11701. Register here.

 

We cannot change the past, but we most definitely can shape the future so we will someday be able to celebrate the absence of disparities in health care.