By Jack Bernard
AL.com (Huntsville, Ala.), Sept. 23, 2016
Black Lives Matter has its supporters (43 percent of Americans, per Pew Research Center), as well as its detractors (22 percent), but one thing is unmistakable: it has brought visibility to a very real problem. For too long, the general public has ignored the increasingly frequent violence against African-Americans, especially men.
Homicide mortality rates are much higher for blacks (21 per 100,000 population) than whites (3/100,000). Sometimes, this violence is perpetuated by law enforcement officers. All too often, it is done by other black men.
But, homicide is not the only area in which black mortality exceeds that of whites. Unfortunately, the national black health crisis is also being ignored by an unknowing and oblivious public.
The overall death rate per 100,000 African Americans vs. whites is 867 versus 734. In fact, rates are much higher in every mortality area:
- heart disease: 239 white versus 308 black
- cancer: 196 versus 239
- stroke: 55 versus 76
- diabetes: 22 versus 50
- AIDS: 2 versus 23
The causes of higher African-American mortality rates are complex. There are many factors to consider, including: income, education, gun policies, the ingrained racism that stubbornly persists in our theoretically egalitarian society and health insurance being tied to employment (which is also related to historical racism).
In this short narrative, it is impossible to fully cover all of these topics in detail, but let’s look at the situation from the 20,000 feet view.
Income and employment are directly tied to health status in our society. Americans who have insurance and can afford health care utilize these services at a much greater rate than those who are without assets and insurance. This is not only a fact, it is intuitive.
Education, unemployment and income are inter-related. People who are better educated are able to find and keep their jobs, and get new ones if their jobs are lost. Likewise, higher education and employment leads to higher income.
Undeniably, our nation has a shameful history of prejudice against African-Americans, going back centuries. Although we have made tremendous progress in the last few decades, the legacy of slavery still exists.
Simplistically, let’s look at this as in terms of a foot race. If one contestant has his feet tied together for the first portion of the race, how hard will it be for him to catch up after he is untied? Who can say how long it will take? Our racial history is the cause of these inequities.
Black income levels continue to be much lower than whites ($35,398 vs. $60,256- 2014 Census). Likewise, 2016 2nd quarter black unemployment rates are higher (8.3 percent vs. 4.2 percent – BLS). Partly because health insurance in America is closely tied to employment and employers, the uninsured rate for African-Americans in 2016 is also higher (11.4 percent vs. 6.4 percent- Gallup, 4-16).
There are a multitude of actions that can be taken by America to correct the situation with regard to education, employment and income. Once again, our space is too limited to address these issues. However, I would like to return to the question of health insurance.
When we examine the other developed nations of the world, we find that every one of them provide for universal health insurance for all of their citizens. In America, even after the Affordable Care Act (ACA, Obamacare), we are still left with 30 million uninsured, many of them minorities.
Unfortunately, neither political party has put forth a realistic way of addressing this problem. Democrats want to tinker with the ACA, which will make only minor improvements to the uninsured percentage. The GOP wants to privatize and incentivize, ignoring the basic problem (the private insurance system) and almost certainly worsening the situation for many citizens. And, neither party has advocated for the obvious solution as part of their platform: Medicare for All.
The American public sees a national plan as preferable to the ACA. According to a recent Gallup poll, 58 percent of those surveyed were for it and no wonder.
Premiums are constantly going up for employees as employers cost shift their increasing benefit expenses, driven by insurance companies which are in turn battered by rapidly rising drug prices by price-gouging international pharmaceutical corporations. Bloomberg (6-16) surveyed a sampling of 39 common drugs and found prices for 30 had doubled from 2009 to 2015.
Single payer provides for leverage and cost control. It is the only way to get the rapidly rising cost of health care (currently paid for primarily out of government funds, just not effectively) under control.
The adoption of single payer provides for health insurance for all Americans, removing one of the major barriers to improvement in health care for African-Americans and other minorities, while helping white Americans as well. Rep. Conyers of Michigan has repeatedly introduced Medicare for All bills in the House. It is long past time for members of both parties to unite in backing this legislation.
Jack Bernard is a retired healthcare exec and the former Director of Health Planning for the State of Georgia. He was also on the Jasper County Board of Health and County Commission.