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Racism In Medicine: Part Two :: The Misguided Explanations For Health Care Disparities

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Has anyone noticed how the new U. S. backed "Road Map" for peace in the Middle East region has seamlessly turn the nation's attention from war in Iraq to that noble but oft-failed Israeli-Palestinian peace process?

Here at home Congress is in a dog fight over whether the President's tax cut proposal will benefit the rich or help the other 95 percent of Americans. Meanwhile, millions of families ponder the reasons for the persistence of health disparities in the most affluent country on earth and the country that spends more on it’s healthcare system than any other. Or why the gap in health status between rich and poor actually widened between 1983 and 2002. Such issues are said to be top priority at the National Center on Minority Health and Health Disparities (NCMHD), a federally funded center of the National Institutes of Health since 2000.

The NCMHD was designated by Congress to lead, coordinate, support and assess the NIH research effort to reduce and ultimately eliminate health disparities that affect racial/ethnic communities and the medically underserved. NCMHD Director, John Ruffin concedes despite billions of dollars spent on medical research and recent medical advances, at least 44 million Americans have no health insurance, and almost equal number are underinsured. In addition, Ruffin says "more than 30 million Americans live in medically underserved areas." It's a paradox of improving the health status for some coupled with the widening disparity in health status for others.

Ruffin cites two key factors, poverty and a gross lack of inclusivity. "If we are to solve these problems we must be more inclusive in our research endeavors." He notes, "our diverse population fails to benefit equally from recent medical advances for reasons we have yet to fully understand." The benefits from our past investments in biomedical research do not reach all our citizens equally.
The poor and the nation's minorities have been left behind.

With only 6% of the world's population, the U. S. has produced almost half of the Nobel Prize winners in physiology and medicine throughout the 20th century. We have the most highly trained health professionals in the world and the world's most advanced technology, yet less than 5% of all NIH grants are awarded to African-American investigators at all institutions minority or not.

In 1998, a federally funded program aimed at recruiting more African-American research investigators, was declared "preferential" and unconstitutional by a Pennsylvania court. In 1999 the National Cancer Institute‚s $3 billion budget allocated only 23 million to investigators looking specifically at cancer treatment and prevention for minority populations.

So what have the last 20 years taught the medical community about improving increasingly obvious disparities in health status? The vast disparities in critical health indicators between whites and every ethnic and racial minority in the U. S. , is economically and racially motivated. And the locus for most federal programs aimed at ending health disparities is as muddled and misguided as the debate over who benefits from the President’s proposed tax cuts.

Dr. Levister welcomes reader mail concerning their body but regrets that he is not able to answer individual letters. Your letters will be incorporated into the column as space permits. You may direct your letters to Dr. Levister in care of Black Voice News, P.O. Box 1581, Riverside, CA 92502.

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