Right now in 2020, all across the U.S., even BEFORE the coronavirus pandemic arrived, data showed that people of color—Black, Hispanic, Native American, Alaskan Native, Asian American, and others—suffer disproportionately from some of the most devastating health problems, from cancer deaths and diabetes to maternal mortality and preterm births.
Seventeen years ago, in 2003, “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care” a panel of experts explored the evidence as well as how persons of color, like the stories I shared in my remarks, experience the health care environment. The report examined how disparities in treatment arise in health care systems and looked at aspects of the clinical encounter that contribute to such disparities. Patients’ and providers’ attitudes, expectations, and behavior were analyzed.
Perhaps as a result, seven years later, in 2010, Offices of Minority Health (OMH) were established within multiple agencies at the Department of Health and Human Services–some of which you might recognize—Centers for Disease Control and Prevention (CDC); Centers for Medicare & Medicaid Services (CMS); Food and Drug Administration (FDA); and Substance Abuse and Mental Health Services Administration (SAMHSA). These offices join the HHS Office of Minority Health and NIH National Institute on Minority Health and Health Disparities to lead and coordinate activities that improve the health of racial and ethnic minority populations and reduce health disparities.
Sadly, though, the last biennial report to Congressposted on the OMH website was from 2015. It is disappointing and a bit surprising to think that there has been nothing to report since then.
What IS on the HHS Office of Minority Health website are various ‘fact sheets,’ including these samplings:
African Americans have the highest mortality rate for all cancers combined compared with any other racial and ethnic group.
In 2017, American Indian and Alaska Native adults were almost 3X more likely to have diabetes than non-Hispanic white adults. They were also 2.5X more likely to die from diabetes.
The incidence rate of tuberculosis for Native Hawaiians and Pacific Islanders is higher than in any other population.
In 2017, the number of suicide attempts by adolescent Hispanic females was 40% higher than that of adolescent non-Hispanic white females.
There is no doubt that health disparities impact clinical outcomes for many minorities. But what is also troubling is that the everyday experiences that non-white patients have also result in less willingness to access healthcare, less trust in providers, and in our one patient’s story, accepting rude and unprofessional behavior from her physician and the office staff.
Our health care system and the people in it must do better. Many health care leaders have asserted that alleviating health disparities will require a deliberate and sustained effort to address social determinants of health, such as poverty, segregation, homophobia, environmental degradation, and racial and gender discrimination. Given all the other challenges our country is facing, how ’bout if we just start with the Golden Rule?