Health care: the racial divide

The Tennessee Department of Health's Office of Minority Health has released a 108 page report entitled Populations of Color in Tennessee: Health Status Report (PDF format). From the report's introduction:

Purpose

The purpose of this report is to compile data and pertinent information from a wide variety of sources to provide a complete description of the health, lifestyle, social and economic conditions which contribute to disparities affecting minority populations.

Background

Tennessee has lagged behind the health of the rest of the nation for a number of years. In terms of overall health ranking, Tennessee is one of the least healthy states. Not only is the overall health poor in Tennessee when compared to other states, but the health disparities between African-Americans and whites are considerable.

Judging from some of the findings listed in the executive summary, that's an understatement:

Life expectancy: At all ages, African-Americans have a shorter life expectancy than whites in Tennessee. In fact, a white baby born in 2002 was expected to live 5.2 years longer than its African-American counterpart.

Violence: Homicide is a serious issue for African-American males in Tennessee. Based on 2001-2003 data, African-American males aged 15 to 24 years die from homicide at a rate that is more than 31 times that of white females. (The detailed analysis notes that among 15- to 34-year-old African-American males, homicide is the leading cause of death, and that death from assault involving a gun is much higher than for whites.)

Infant mortality: Tennessee's infant mortality rate is 8.6 infant deaths for every 1,000 births, ranking the state 48th worst in the country. The infant mortality rate among African-American Tennesseans was over two and a half times the infant mortality rate among whites in 2003.

Economics: The economic differences between whites and African-Americans are significant. African-Americans have higher unemployment rates, lower median household income and much lower levels of personal wealth than their white counterparts. In addition, African-Americans are more likely to rent than own their own home, making accumulation of wealth difficult. African-Americans are also more likely to be below the poverty level based on the 2000 United States Census.

Chronic disease: African-American Tennesseans in 2002 were hospitalized at nearly three times the rate of whites for diabetes-related morbidity. Stroke related hospitalization occurs at an approximately 50 percent higher rate among African-Americans than whites. [..] Breast cancer occurs at a 12 percent higher incidence among white women; however, the mortality rate from breast cancer is 48 percent higher for African-American women.

The report covers these and other areas of study in great detail across a variety of socio-economic and demographic breakdowns. At the end of the report, there are summaries of town hall meetings held across the state and citizen input of ideas on how to address the problem. Based on those comments and analysis of the results of the study, the report concludes with several pages of suggested strategies that could be pursued.

From the report's concluding remarks by the Office of Minority Health:

The question that was repeated during our meetings with community groups across the state was far beyond the scope and substance of this basically descriptive report: "What are the underlying causes for health disparities?" The answer is complex. Issues such as access to healthcare, differing educational levels, cultural biases, de facto segregation, proximity to environmental hazards, genetic predispositions, different treatment approaches by healthcare professionals for people of color, higher underemployment and unemployment, low income, low levels of wealth and lifestyle choices are all cited as possible explanatory factors for differences in health outcomes.

[..]

The current approaches are clearly not working. Although minority groups such as African-Americans have improved their overall health over time, the actual disparity between populations of color and white population persists. Clearly, the challenge is to find new, creative approaches that actually work, and not to accept anything less than the reduction and ultimate elimination of racial and ethnic health disparities.

The report was presented at a press conference kicking off Tennessee's 11th annual Health Summit of Minority Communities, which is being held in Knoxville this week.