Back Of The Bus On Health Care

December 10, 2006
Commentary By JANET DAVENPORT

When my mom, who'd survived breast cancer, complained of a strange cough and lightheadedness, her doctor listened to her chest and sent her home. Her symptoms persisted. Fortunately, so did she.

Following several office exams, she demanded tests. A chest X-ray revealed lung cancer. That was seven years ago. Luckily, she has beaten both bouts of cancer.

This past Thanksgiving, four generations of family members gathered around the dinner table. We were thankful to have my mother, 77, and father, 85, among us. But we revisited the question lingering in our minds since my mother's latest cancer battle:

What if she had been a white woman with top-notch private health coverage instead of a black woman with top-notch private insurance? Would her doctor, who was white, have been more proactive in diagnosing the deadly disease in her lung? Such gristle is standard fare at black family dinner tables.

Experts are also starting to chew more thoughtfully on racial and ethnic equality in health care.

Until recently, health gaps between whites and minorities were blamed on poverty, lack of insurance and genetics. Conventional wisdom suggested that these gaps would close as more minorities became middle class. However, that's not panning out. Despite substantial educational and economic gains among African Americans, health gaps remain remarkably unchanged.

The disparities, especially between black and white infant mortality rates, are shocking: The divide between the two is proportionately the same as 40 years ago.

Mirroring the country, black babies in Connecticut are almost three times more likely than white babies to die in their first year of life. In Connecticut, the death rate for black babies is 14.2 per 1,000 births, compared with 5.4 deaths per 1,000 births for white babies.

More troubling, reports by the U.S. Department of Health and Human Services show infant mortality rates for the most educated black women exceed those of the least educated white women.

In truth, the health care pictures of African Americans and Latinos, now the largest minority group, are awful. Blacks and Latinos are still more likely than whites to die younger, suffer higher incidences of infectious and chronic diseases, and receive treatment for deadly diseases such as cancer in much later stages.

And even when their income, education and insurance coverage are the same as whites, blacks and Latinos receive lower levels of medical service. Reports by the Connecticut Health Foundation and the Journal of the American Medical Association, among others, chronicle outrageous discrepancies in levels of treatment and care.

White patients are also more likely than minorities to get the medical tests and treatments they need. This is inexcusable racial discrimination. More than 40 years after the Civil Rights Act and despite amazing medical advancements, such gaps are unacceptable.

Few people know this chilling reality better than my mother. When she suspected a recurrence of cancer seven years ago, she immediately sought medical attention. Fortunately, my parents retired comfortably and maintain high-quality, although outrageously priced, private health insurance.

Still, my mother did not receive the tests necessary to diagnose her cancer right away. After repeated office exams and several months of worry and frustration, she demanded X-rays and blood tests.

Her assertiveness led to a diagnosis and the surgery that ultimately removed the mass growing in her right lung. Fortunately, the cancer was caught early.

Following her surgery, her surgeon said that my mother saved her own life. There is no question about that. But my mother's battle also raised unsettling questions about the equality and quality of our health care.