Geographical, cultural, and monetary barriers that keep people from receiving health care are like ’toxic cloud,’ speaker says

Thursday, September 15, 2005

TYLER -- Imagine a toxic cloud smothering parts of the United States, killing people. But those dying are poor, are black or Hispanic or Native American, don’t speak or understand English very well, can barely read, or live in small rural communities without reliable transportation.

Geographical, cultural, and monetary barriers to receiving adequate health care in the United States have the same effect as such a toxic cloud, said Marsha Regenstein, Ph.D., vice president for research at the National Association of Public Hospitals in Washington, D.C. She spoke Thursday during the first day of "The ABCs of Health Disparities: Access, Behavior, Costs," a conference sponsored by The University of Texas Health Science Center at Tyler at the TASCA Ornelas Activity Center in Tyler.

A recent study showed that, if African-Americans in the United States had enjoyed the same improvements in health care that whites did from 1991-2000, more than 886,000 lives could have been saved, Dr. Regenstein said. Because of racial health disparities, the study estimated just 176,633 lives were saved during the decade, she said. The study’s results were published in 2004 in the American Journal of Public Health.

"I think that what’s happened in New Orleans is a health disparity," Dr. Regenstein said, referring to the death and devastation wreaked by Hurricane Katrina and the inadequate response to that disaster. Many residents left behind in the flooded city were African-Americans who lived in low-income neighborhoods that were the most vulnerable to flooding.

"Health disparities are pervasive. They affect all parts of the country and all types of services," Dr. Regenstein told the crowd of about 100 people. Still, there’s not a lot of information about how much money the unequal delivery of health care costs the United States.

"I think there’s a lot of bang for the buck when you address chronic conditions, especially those such as diabetes, asthma, and HIV/AIDS" she said. But there’s no guarantee ending health disparities would reduce the total amount of money spent on health care.

While most medical professionals recognize that health disparities exist, they don’t acknowledge their role in them. "I think the individual provider has not made the leap that he or she might individually contribute to these disparities, because that’s an uncomfortable position to be in," Dr. Regenstein said.

Christie Osuagwu, director of Community Outreach and Health Disparities at UTHSCT, said minorities aren’t the only people affected by unequal access to health care.

"There are many whites who face health disparities because they live below the poverty line. Poverty is a baseline for health disparities," said Osuagwu, a nurse practitioner who has a master’s degree in public health.

Dr. Paul McGaha, regional director of the Texas Department of State Health Services (TDSHS), spoke of the health care needs of Hurricane Katrina evacuees.

"We have a new health disparity in our own back yard. Our population has increased by thousands. These are people who came (to East Texas) without a medical history, without medications," Dr. McGaha said, praising the volunteers who have mobilized to take care of evacuees.

"UT Health Science Center has stepped up to the plate and helped enormously. That kind of response has been happening all over East Texas, in Gregg County, in Nacogdoches County," he said.

The increase in the number of economically disadvantaged people using public health care will strain local resources, Dr. McGaha said.

"It will take a major investment by all, including the medical and health-care providers, to address this. Our population in Tyler increased 2 or 3 percent. That’s going to cause some issues. This is a good opportunity to help our friends in need, and to assess the delivery of health care, not only to these displaced people, but also to our local population," he said.

Dr. McGaha and Osuagwu spoke in place of Kimberly McCoy-Daniels, director of the Office for the Elimination of Health Disparities at the TDSHS. McCoy-Daniels was unable to attend the conference due to a sudden illness.

Today, UTHSCT President Dr. Kirk A. Calhoun and UT System Executive Vice Chancellor for Health Affairs will speak on, respectively, geriatric health disparities and health disparities in America.

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