Calls for persistence in closing health care gap
Of the St. Louis American
On Saturday afternoon, former Surgeon General Dr. David Satcher spoke to Salute To Excellence in Health Care guests much like a country doctor confers with patients as he addressed the persistent disparities in health care between African Americans and the general population.
One of his prescriptions for improving African-American health during his keynote address does not come in a bottle, nor is it a pill or medication. It can only come from the human spirit.
“We must have hope,” Satcher said.
“There is hope vs. hopelessness. If black children feel they don’t have a future, they will make the wrong health decisions. Children must somehow see hope in their future.”
Satcher, who serves as interim president of the Morehouse University School of Medicine and is director of the National Center for Primary Care at Morehouse, recently published a landmark paper on disparities in health care.
He said that a large number of African-American lives could be saved if the gap in health care had been eliminated over the past century.
“There would be 85,000 fewer African-American deaths,” he declared.
“That would consist of 22,000 less deaths because of health disease, and 17,000 fewer HIV/AIDS-related deaths.’
Satcher also said that no study or committee could reduce the gap in health care between black and white Americans unless there is a change in attitude.
“This is the importance of policy – unless that is changed, it won’t happen. Unless we make a commitment to universal care, people who are behind will never catch up,” he said as more than 500 guests applauded.
The U.S. largely has an employer-based, insurance-administered health care system.
“This commitment has to start at the local level, with the people that we vote for. If the attitude does not change, we are never going to solve the problem,” Satcher said.
Satcher mentioned federal Medicare cuts; Gov. Matt Blunt has made dramatic slashes to the state’s Medicaid budget, as well. Satcher called the two publicly funded single-payer programs “the most efficient health care delivery systems in our history.”
“What must be determined is how healthy are people going to be. Health is impacted by biology, lifestyle and behavior, and physical environment,” Satcher said, adding that the World Health Commission is now working feverishly on “how to attack social elements, including poverty, that help make the divide in health care wider.”
Satcher said African Americans are “under-represented, under-inspired, untrusting and uninformed” when it comes to personal health care.
“We need more diversity. We are also not closing the gap in getting more African-American men into health care. There has been a 20 percent decline (in black men enrolling in medical schools) since 1996, and a 2 percent decline in black women enrollment,” he said.
“This creates a significant difference in quality of care.”
While he didn’t make the crowd restless, a hush came over the audience when Satcher addressed health care and human sexuality.
He called it “the subject no one wants to talk about.”
“We need to talk to our children about sexuality. This goes back to the importance of hope. If somebody is convinced that they are not of value, and all they have is sex, they will make bad decisions about sex,” he said.
“We should talk with our children about sex, just like other health issues. We must remember people are sexual beings, even if they are not sexually active.”
Another taboo in many black households is discussion of mental health problems.
“Just as things go wrong with the heart or lungs, so it is with the brain,” he said.
In closing, Satcher said that knowledge is not enough to successfully deal with the health care divide in the United States.
“We must care enough. We must be willing to do enough and we must be persistent in our efforts,” he said.
“We cannot close the gap with what we know; we must close the gap with what we do.”
