The Medical Minute: Focus on minority health

April 21, 2004

By Dr. John Messmer,
Penn State Milton S. Hershey Medical Center

Much has been accomplished in prevention and treatment of disease over the last quarter-century. Americans are living longer and healthier lives with even greater future potential through medical advances. The problem is that these improvements have benefited mostly white Americans. Minority health continues to lag behind.

In 1975 cancer death rates for men in poverty -- which statistically speaking tend to be minorities -- were only 2 percent higher than in more affluent men according to the Intercultural Cancer Council Caucus. By 1999, the difference had grown to 13 percent. African-Americans and Alaskan Natives have the highest rates of cancer deaths in the U.S. The problem is attributed to poverty, as poor white Americans have similar rates of cancer death.

Primary-care prevention can cut the rate of cancer in half, but these services do not reach the most-affected populations in sufficient quantity. The poor are less likely to be screened for cancer and tend to have more advanced cancers when diagnosed. Only 38 percent of Hispanic women more than 40 years old have been screened for breast cancer with a mammogram. Asian and Hispanic women who comprise a large portion of low-income families are less likely to receive Pap smears to screen for cancer of the cervix. Smoking, which is responsible for 87 percent of lung cancer deaths, is common in African-Americans, among whom 34 percent of men and 23 percent of women smoke, Puerto Rican Hispanics (27 percent) and Native Americans (40 percent).

Other diseases have similar discrepancies. Diabetes is 85 percent more prevalent in African-American women than in caucasians. Black women have higher pregnancy-related death rates and several-fold higher case rates of AIDS. Although breast cancer is not as common in black women as whites, blacks have a higher death rate from the disease.

Hispanics and African-Americans are twice as likely to have diabetes as whites. Black infant mortality is about 2.5 times the rate for whites. Hispanics and African-Americans more than 65 years old are less likely than non-Hispanic whites to have received influenza and pneumonia vaccines.

This should still matter even to those who are not in the affected groups. Besides the human toll, it is more costly to manage advanced disease. These costs are passed on in the form of higher taxes and increased health insurance premiums. Health-care providers are generally not considered to be at fault for these discrepancies. Rather, health-care policies that reduce reimbursement for medical services or inadequately cover screening and do not prioritize smoking cessation are considered a significant part of the problem. Inadequate health-care education for the poor also is a detriment.

April is National Minority Health month, and in an effort to reach out to areas of our population that do not have adequate access, the Penn State General Clinical Research Center is providing a health fair in downtown Harrisburg on May 1. For more information, see http://www.hmc.psu.edu/news/pr/2004/apr/health_fair.doc

National organizations from the Department of Health and Human Services to the Centers for Disease Control and many private groups have promoted increasing awareness for minority health. Everyone can contact legislators to encourage them to provide the legislation needed to provide for the underserved minority segment of the population.

A good place to learn more about minority health needs and related issues is the Penn State University Libraries system at http://www.libraries.psu.edu/lifesciences/multicultural/

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Last Updated March 19, 2009