Clay holds forum to discuss disparities
By Meliqueica Meadows
Of the St. Louis American
Congressman Wm. Lacy Clay held a forum at Saint Louis University Saturday to discuss health disparities in the region. Congresswoman Dr. Donna Christensen, Democratic representative from the Virgin Islands and chair of the Congressional Black Caucus’ Health Braintrust, co-hosted the event.
Moderated by Julius Hunter, the panel included local doctors, health care professionals and advocates. Three key points framed the health disparities discussion: defining the problem, assessing the problem and finding solutions.
Dr. Christensen said she is currently working on a health care act that would help increase access to health care and medical coverage for the citizens that most need it.
“Introducing the bill is just the first step. This will need your help,” she told the public.
“We have the resources in this country. We spend close to two trillion dollars on health care every year. That’s close to $5,000 per person per year – and a lot of people in this country, especially people of color, are not getting their $5,000’s worth.”
The money to fund health care could be found in the federal budget, according to Dr. Christensen.
“We can do better, but our priorities are off,” she said.
“The war in Iraq, tax cuts that only help the wealthiest in this country, and offsets for Katrina are threatening to cut the cuts that were already in our budget even more.”
Dr. James Kimmey, president and CEO of the Missouri Foundation for Health, provided current statistics for health disparities in the region. To ensure that audience members understood the numbers, he had everyone in the audience stand up to illustrate his points.
“These members of the population will die after 63.9 years,” Dr. Kimmey said after directing all of the African-American men in the room to sit down. Next to sit were white men with a life expectancy of 72.6 years, followed by African-American women at 74 years. White women have the longest life expectancy in Missouri at 79.4 years.
“I think this points out one aspect of the problem, and that’s the tremendous diversity in life expectancy based on race in this country at this time,” Dr. Kimmey said.
“The rate of infant deaths among African-American babies in Missouri is 2.6 times that for white babies, and an African-American baby is twice as likely as its white counterpart to be of low birth weight.”
Dr. Kimmey said race-based health disparities are the result of systemic racism.
“Our institutions are structured in a way that perpetuates the idea that some people are less worthy, less deserving of time and less deserving of good services than are others,” he said.
“Those institutional barriers have got to be broken down.”
Bill Dotson, chief of the Bureau of Family, School and Community Health for the city of St. Louis, based his remarks on the latest Understanding Our Needs report published by the city’s Department of Health, which compiles data on health disparities by ZIP code.
“Our healthiest ZIP codes in St. Louis continue to be 63109, 63139 and 63116. ZIP codes that are of the most concern when it comes to health disparities are 63106, 63107, 63113, and it was the same in the previous report,” Dotson said.
“Those ZIP codes happen to represent white populations versus African-American or minority populations, and we’re concerned about that.”
During the brief question-and-answer period that followed the first segment of the discussion, one audience member, who had counted the number of times Dr. Kimmey had used the word “racism” in his brief remarks, said he felt that word would alienate right-wing conservatives and prevent progress in solving the problem.
“Precisely the problem with racism is we don’t recognize it, but we practice it,” Dr. Kimmey said.
People’s Health Centers CEO Betty Kerr spoke during the portion of the discussion dedicated to assessing the problem of health disparities in St. Louis.
“We all know that prevention is the best cure for disparities, but those are the areas that get cut first,” Kerr said.
“If you look at the state and the Medicaid cuts, the first thing they cut for the adults were their dental services. If you don’t detect problems that can lead to more catastrophic problems, then the gap gets wider.”
Will Pittz works for the Northwest Federation of Community Organizations and is the lead author of Closing the Gap: Solutions to Race-Based Health Disparities. He said a prevailing myth about the cause of health disparities as they relate to race is that the problem is due entirely to genetics.
“It’s simply untrue. The Human Genome Project and other efforts have proven the biological and genetic differences within racial and ethnic subgroups are much greater than differences across races,” Pittz said.
He said another myth regarding health disparities is that their causes lie primarily within the health care system.
“The fact is that the primary causes of health disparities are persistent discrimination in housing, education and employment,” Pittz said.
“African-American children suffer more from asthma, and the reason for that is they are twice as likely to live in polluted neighborhoods or to live in substandard housing. There are twice as many Superfund sites and toxic emitters in neighborhoods that are primarily of people of color.”
Clay stressed the same point.
“Environment has a lot to do with health care and diseases. When you think about St. Louis and the lack of quality air, that contributes to the high incidences of asthma,” Clay said.
“People of color have higher cancer risks and suffer more workplace injuries because they occupy the riskiest occupations. The 10 occupations with the most Latino workers are three times more dangerous than the 10 occupations with the most white workers.”
When the discussion turned to finding solutions to the problem of health disparities, Dr. Vetta Sanders Thompson, an outspoken associate professor at the SLU School of Public Health, said it would take a coordinated effort to end the problem.
She cited the need for people to correct their own self-destructive behaviors, disourage the rampant promotion of tobacco use in the African-American community and address the high concentration of “non-board certified physicians who may not be as adherent to evidence-based practice” in minority communities.
“There is no single solution to health disparities,” Dr. Sanders said.
“This is a complex issue and we will have to implement several solutions simultaneously. We will have to prioritize among the solutions we attempt to implement.”