Something that agitated me on the Bus yesterday.

[lostparker17]

It matters because African Americans need to know their risks. Just like a poster might say, "Sexually active gay dudes are more likely to have syphillis and Aids than any other group". It's a health warning.

Let it go.

 

[Lube]

Diseases don't select one group of people. That's my problem.

Yes, they do.

 

[Lube]

I guess I completely missed something then.

Take this Google search for example. It's enlightening.

 

[Lube]

Oh, sorry, just realized my browser is set to search Google.ie (Ireland). You'll get different but equally interesting results searching at Google.com. Didn't realize there'd be such a difference.

 

[lonnie1]

The reason you see those kind of messages is to communicate to a particular race that they are more prone to have a certain problem. For example, statistically African--Americans are more likely to get sickle cell anemia so they need to be aware of this. Other races are prone to get other diseases. If a certain race becomes aware that they are prone to a disease, they can learn to recognize signs of a problem and perhaps get treatment earlier which can prevent expensive emergency room visits and hospitalizations.

 

[slobone]

It matters because health resources are finite, and they can be channeled better if medical people know where the risks lie. You wouldn't put as much energy into screening non-smokers for lung cancer, for example, even though they can get it. Or Type II diabetes for people who aren't obese.

You have to distinguish between statistics that apply to groups of people and projecting those generalizations onto individuals.

For example, young men age 18-25 are more likely to be involved in car accidents than older men. Insurance companies need to know that so they can set their rates. But it wouldn't be fair to deduce that my neighbor's son is automatically a bad driver (he is, but that's neither here nor there).

Similarly, an individual black man may or may not suffer from hypertension. But doesn't it make sense for a public ad campaign to alert him to his increased susceptibility to it?

 

[lostparker17]

It matters because health resources are finite, and they can be channeled better if medical people know where the risks lie. You wouldn't put as much energy into screening non-smokers for lung cancer, for example, even though they can get it. Or Type II diabetes for people who aren't obese.

You have to distinguish between statistics that apply to groups of people and projecting those generalizations onto individuals.

For example, young men age 18-25 are more likely to be involved in car accidents than older men. Insurance companies need to know that so they can set their rates. But it wouldn't be fair to deduce that my neighbor's son is automatically a bad driver (he is, but that's neither here nor there).

Similarly, an individual black man may or may not suffer from hypertension. But doesn't it make sense for a public ad campaign to alert him to his increased susceptibililty to it?

Wow. The best explanation I've ever seen!!!

 

[DarkNeko]

I'm a Sephardi Jew and there are some diseases/illnesses that I need to look out for because they affect my ethnic group more than others:

Beta-Thalassemia
Familial Mediterranean fever
Glucose-6-phosphate dehydrogenase deficiency and Gilbert's Syndrome
Glycogen storage disease type III

 

[DiaryOfAMadman]

Sorry Bled but it is very important to get that message out to the public. YES there are diseases that only affect certian people, for example only people of African decent can have "sickle cell anemia".

At least in the US, African americans have the highest rates of "hypertension" (high blood pressure), which in turn leads to more incidents of strokes. Tehy must check this out more regularly then normal and it gives them the chance to correct high blood pressure early via medication. As a group they also have higher then average incidents of heart disease in some studies.

I see your anger, however I feel it is very important to get this information out espically to a group that major media donse't cater to. No offense but we know that society and espically big business here in the US is raceist. Therefore many compaines and orginazations feel no need to try to catch the African American demographic. So these "no nonsense" advertisements are very important.

 

[NongreasySweatproof]

Race matters for disease in some ways, and not in others. "Race" is a convenient way of summarizing general physical traits that people from certain places of the world tend to have more often, on average. But it's also a somewhat arbitrary division of humanity. Medical studies could just as easily be partitioned by other traits, such as the presence or lack of certain enzymes, bloodtype, the presence of particular protein receptors on cells, etc. Some of these traits CAN be characterized as "racial," but it's not the only way we could divide people. This is also relevant for pathology: thalassaemia is a blood disease that is much more common amongst Mediterranean and Southeast Asian populations than amongst other groups; osteoporosis and susceptibility to skin cancer are more common in Europeans and East Asians; susceptibility to diabetes is greater among those with native American and Pacific Islander ancestry. All of these factors are genetic, and all of these factors line up closely with where your ancestors came from, but they don't necessarily line up with neat, racial categories.

Knowing that a person is black, white, etc. DOES allow you to revise your prior expectations of his likelihood of getting particular diseases, but so could certain other partitionings. We've decided, as a society, to classify people by skin color and eye shape, but we could have just as easily chosen other traits with which to divide ourselves. In our medical studies, we've simply chosen to divide people along lines that are externally observable and that also conform with how society chooses to categorize people.

 

[slobone]

^^^ It's true that the criteria we all use in everday life to categorize people by race aren't necessarily justifiable scientifically. A person can be considered African-American, for example, even if they have more European ancestors than African ones. But even if these categories are relative rather than absolute, that can still make a difference when it comes to health.

I don't believe it's known for sure yet why African-Americans have more hypertension than other "races." It could be genetic or it could be cultural. Living in a stressful neighborhood, or having an unhealthy diet, are suspected factors. And needless to say, plenty of white people suffer from hypertension too.

There's a HUGE amount of research going on about this, so naturally the results aren't in yet.

 

[blooeyz]

You first mistake was riding a bus

 

[Yves]

Racial and ethnic disparities in health have been described in the US in recent years. Differences in morbidity and mortality among ethnic groups are particularly relevant when those differences are explained not just by random but because of preventable structural factors (differential access to health care, differences in behavioral and environmental risk factors, etc)

Organizations as Physicians for Human Rights (PHR) and public health researchers have provided a significant amount of evidence on ethnic disparities in health care in recent years. A panel was convened in 2003 that resulted in the identification of differences by race/ethnicity in diagnostic procedures and treatment for a good number of diseases. Some local governments are now using that evidence to correct for sources of inequality. The poster on the bus seems to higlight some of the differences that have been described in the scientific literature but it doesn´t provide a clear explanation. Some people may believe that differences among ethnic groups are "just natural or biological" in essence. Most of the variation can not be explained by biological factors alone. The explanation is not genetics but a wide range of the so called "social determinants of health".

There are a good number of diseases (diabetes, cancer) where differences observed across ethnic groups can not be explained by genetics alone. A case in point is breast cancer. African American women tend to exhibit worse rates and in many cases is due to late detection (i.e. worse prognosis). White women (as a group) are detected earlier and as result the cancer has a better prognosis. Why late detection among Adrican American women? Inadequate access to health services, lack of universal health care, lack of adequate campaigns targeted to minorities, etc. Economics play a major role here. Functional illiteracy is another barrier to consider. The data available is based on the analysis of groups. Individual cases may not fit this pattern but when you look at women as a group and then by ethnicity is possible to observe patterns that can not be explained by biology alone. In many case the key problem is to live in poverty conditions, have limited access to health care and a mistrust of the health care system.

Cities as New York and others allocate funding for campaigns in Spanish and other languages in order to correct for preventable sources of inequality (access to information). Another factor to consider are potential differences in the natural history of a disease (sickle cell anemia in AA). Some groups are more prone to particular diseases. Another factor is socioeconomics. Think about obesity. Overweight and obesity are a major public health problem in the US and the effect of junk food is even worse among the poor. The number of obese teenagers keeps increasing and that will result in additional problems and burdens to the health care system. Reserchers have demonstrated that those obese living in inner cities are exposed to worse health outcomes not because of their ethnicity but because of lack of healthier food alternatives (at lower prices) and relative lack of access to health services compared to those living in the suburbs. Studies have been replicated in large cities and the findings are consistent.

A nature disaster as Katrina revealed the role of social inequalities in health and disease in the US. Most of the victims were either poor and/or minorities (those with no access to cars, emergency funds or adequate health insurance). A good number of those with adequate means had time and resources to escape at the right time, but the story was very different for those left behind (the poor). In that case a disaster that should have affected everybody independent of social standing ended up affecting minorities more significantly. Overrepresentation is the key word here. The problem of inequalities has to do with overepresentation of minorities due to preventable factors (inadequate access to health care, lack of information, higher illiteracy rates, etc.). Minorities are overrepresented in some diseases and some of the factors are preventable via public policy. Discrmination is still a problem in the US in some degree, not as significant as 50 years ago but it takes time to get rid of some those preventable factors. Racial segreggation was a reality only 60 years ago.

Attached is a link to a comprehensive New York Times article on Social Class and Health in the US that summarizes the evidence and uses New York data to describe preventable sources of inequality:
http://www.nytimes.com/2005/05/16/national/class/HEALTH-FINAL.html?ei=5088&en=8359d268f2ff6171&ex=1273896000&partner=rssnyt&emc=rss&pagewanted=all

 

[WYSIWYG]

Considering that African Americans like other nationalities here in the USA do not have ANY health insurance, it is nice that the hospital give public awareness of this issue, but a high percentage of the nationality like others, would not get to even see a doctor to get treatment, never mind get treatment at the hospital. One of the first things they ask when your admitted, "Do you have insurance?". We can spend a billion dollars a day on wars, but none for the health of our people in the USA! What is wrong with this picture? The politicians get free healthcare once they are elected!

 

[Austin40acres]

Considering that African Americans like other nationalities here in the USA do not have ANY health insurance, it is nice that the hospital give public awareness of this issue, but a high percentage of the nationality like others, would not get to even see a doctor to get treatment, never mind get treatment at the hospital. One of the first things they ask when your admitted, "Do you have insurance?". We can spend a billion dollars a day on wars, but none for the health of our people in the USA! What is wrong with this picture? The politicians get free healthcare once they are elected!

Can you name, I mean really NAME, one person who has been turned away from an Emergency Room for not having health insurance?

Why shouldn't the government buy you a house?

Why shouldn't the government buy you a car?

Why shouldn't the government buy you a DVD Player and Plasma TV?

Why do you sit around whining about the fact that the "government" hasn't bought you health insurance?

I guess the thought that maybe gay men should be careful and exercise personal responsibility so that they don't get AIDS never entered your mind, huh? Or, maybe it would be better if we all ran around fucking anything we could find and then bitching and moaning that George Bush never got around to creating a cure for HIV or AIDS.

As a white guy, I find it discriminatory that I'm more susceptible to sunburns than African-Americans. Why the fuck hasn't the Bush administration done anything about this????

Goddammit, people!!!




A4A

 

[Lube]

Guess I looked at the issue more blindly then others, oh well.

Hey, after a few more posts, you'll have enough data for a Ph.D.

There's a lot of really bright people here.

 

[Andreus]

ehh

in massachussetts you get fined now if you dont have health insurance

if you cant afford it the state pays

if you have a job and your employer doesnt pay for it he gets the fine

but this isnt about money...

its about making sure that high risk groups are aware of the tests available to save their lives

prophylactic medicine saves millions of dollars and thousands of lives

 

[josher]

Health care is not a luxury (like a DVD player) or a privilige, if you can afford it. It is a basic human right, as most civilized countries have realized. (But of course not the US.)

 

[Yves]

Governments are not expected to buy plasma TV or cars but they are expected to allocate resources to decrease barriers to health care, increase literacy, decrease risk behaviors, etc.
Personal responsability is an essential component for disease prevention and AIDS is a perfect example. Individuals have to assume their own responsibility but the state has to offer some basic conditions and prevent discriminatory policies. Individual responsibility and solidarity are some of the basic principles.

Barriers to access are not isolated. Nearly 43 million people are uninsured in the US. Substantial racial and ethnic disparities exist in health insurance coverage. Disparities correlate with health indicators. In 2002, some 10.7 percent of white, non-Hispanic Americans were uninsured, compared to 20.2 percent of African-Americans, 18.4 percent of Asians and 32.4 percent of Latinos (Source: Health Insurance Coverage in the United States: 2002, Current Population Reports P60-223, U.S. Census Bureau, September 2003).

Nearly 10 million children age 18 and under are uninsured. In some states more than 10% of the children are uninsured: Texas (23%), Florida (15%), Wyoming (13%).
http://mchb.hrsa.gov/mchirc/chusa_04/pages/0604hiscT.htm.
Access to health care is a problem among the uninsured. According to the American Public Health Association:
"Even though the nation’s infant mortality rate is down, the infant death rate among African Americans is still more than double that of whites. Heart disease death rates are more than 40 percent higher for African Americans than for whites. The death rate for all cancers is 30 percent higher for African Americans than for whites; for prostate cancer, it is more than double that for whites. The death rate from HIV/AIDS for African Americans is more than seven times that for whites; the rate of homicide is six times that for whites.
American Indians and Alaska Natives have an infant death rate almost double that for whites. The rate of diabetes for this population group is more than twice that for whites. The Pima of Arizona have one of the highest rates of diabetes in the world. American Indians and Alaska Natives also have disproportionately high death rates from unintentional injuries and suicide."
Source: http://www.apha.org/legislative/factsheets/disparitiesFactSheet.pdf

Access to emergency services is an alternative but not necessarily a solution in some cases. Diseases highly prevalent in children as asthma show significant variation in treatment rates based on ethnicity, income and insurance. Most uninsured children with asthma never see a doctor during the year and many are hospitalized for acute asthma attacks that could have been prevented (Source: Newacheck, P.W., et al. 1996. "Children's access to primary care: Difference by race, income, and insurance status," Pediatrics, 97, 26-32.). Children with untreated illness often cannot keep up in school. Uninsured children are more likely to miss school.