Beyond the Spin: The high cost of inequality

The Philadelphia Inquirer December 25, 2009

If Congress is serious about lowering health-care costs in this country, it must address racial and ethnic disparities that cost thousands of lives and millions of dollars each year.

The report "Equal Health Care for All," published this month by the Center for American Progress, notes, "Health-care disparities generate a significant human and economic cost that is borne directly by the individuals involved and indirectly by all Americans. As minorities become an increasing percentage of the American population, ... the costs of failing to tackle health-care disparities will result in higher total health care spending."

The report notes that:

Infant mortality, one of the most important indicators of a nation's health, was at 6.86 per 1,000 births in 2005. For African Americans, the rate was nearly double that, at 13.63, followed by Native Americans (8.06), whites (5.76), Asian Americans (4.89), and Hispanics (4.42 to 5.53).

Life expectancy at birth in 2005 was 81 years for white females, 77 years for African American females, 76 years for white males, and 70 years for black males. Native Americans have a life expectancy of less than half the national average.

Minorities also have higher rates of chronic illnesses. African Americans suffer 67,000 more deaths from them each year than whites do, one study found.

Although African Americans and Hispanics represented only 26 percent of the population in 2001, they accounted for 66 percent of adult AIDS cases and 82 percent of pediatric cases.

A study conducted by researchers at Johns Hopkins University and the University of Maryland for the Joint Center for Political and Economic Studies, a Washington think tank, calculated that the elimination of health inequities would have saved the U.S. economy $1.2 trillion between 2003 and 2006. That's more than the gross domestic product of India.

"I'm big on advising people about healthy lifestyles," said Dr. David Satcher, a former surgeon general. "I feel strongly about the need to be physically active and to consume fresh fruits and vegetables. But the fact of the matter is that some people live in communities where it's not safe to walk out on the porch, let alone go jogging, whereas other people have walking trails and parks. We're not equal when it comes to healthy lifestyles."

Dr. Willarda V. Edwards, president of the National Medical Association, said the medical community needs to reorder its priorities.

"The National Medical Association has always said we need to work on wellness, not 'sick care,' " she said. "Bring in our insurance companies - who is going to benefit more? It will decrease the incidence of illnesses and really put more emphasis on wellness."