Experts: Minorities suffer from persistent disparities in care

By 
Kyle Cheney, State House News Service
Jun. 12, 2009

The cost of care, access to specialists and inadequate medical equipment are among the numerous barriers to health care for minorities and people with disabilities, advocates for vulnerable communities said Tuesday.

“Injustice and disparities are alive and well in the commonwealth of Massachusetts,” said Rep. Gloria Fox (D-Roxbury), testifying before the Committee on Public Health, which took testimony on 19 bills aimed at narrowing the gap between access to and quality of care for minorities.

Although committee members were scarce – only one of six senators and five of 11 representatives sat on the panel for the first 90 minutes of the hearing – aggrieved consumers, health care experts and their supporters packed Gardner Auditorium in support of the various bills.

Proposals would require health care providers to have medical equipment for people with disabilities, establish a state Office of Health Equity to coordinate efforts to reduce disparities of care, and establish a grant program to fund such efforts.

The hearing came on the same day that U.S. Health and Human Services Secretary Kathleen Sebelius issued her own call to narrow the gap in health care access and outcomes, saying such disparities are a reminder of the urgency of overhauling the U.S. health care system.

In a letter addressed to “friends,” Sebelius said that “Too many Americans are suffering under a health care system that does not work for them.”

“Americans in minority communities have higher levels of disease, fewer medical options, and worse outcomes,” she said.

Sebelius noted that 48 percent of African-American adults suffer from a chronic disease, compared to 39 percent of the general population. Fifteen percent of African Americans, 14 percent of Hispanics and 18 percent of American Indians suffer from adult onset diabetes. And 20 percent of low-income, Hispanic youth have gone a year without a health care visit, three times higher than high-income whites, she noted.

As the Obama administration begins laying the groundwork for a national push on a health system overhaul, she said the disparities “should remind us that reform cannot be postponed another year.”

According to Health Care for All, the infant mortality rate is twice as high for Massachusetts’s black residents than white residents, and blacks are twice as likely to die from diabetes. In addition, asthma mortality rates are four times higher for Latino residents than whites.

Jarrett Barrios, head of the Blue Cross Blue Shield of Massachusetts Foundation, told committee members that the disparities show up not just in outcomes but in access to care. Only three percent of working-age whites are uninsured in Massachusetts, he said, while 6 percent of working-age blacks and 12 percent of working-age Latinos have no insurance.

Obstacles to access could be exacerbated by millions of dollars in cuts to Boston Medical Center, argued the state’s largest health care union, 1199SEIU. BMC, known as a “disproportionate share hospital,” provides care to a large number of uninsured, low-income and minority residents. The unions said 1,000 doctors, nurses and other health workers have signed a letter to the governor to restore cuts to the hospital, which he implemented as state revenues plummeted below expectations.

According to the Put Patients First Coalition, 150,000 BMC patients receive state-subsidized insurance or are uninsured, 94 percent of children served by BMC are minorities and one-third of patients do not speak English as their first language.

Honing in on “cancer disparities,” the American Cancer Society argued that obstacles to care cause late cancer diagnoses, resulting in more severe disease and fewer treatment options.

Sen. Susan Fargo, co-chair of the Public Health Committee, said the Senate budget includes a provision to establish an Office of Health Equity, which she won approval for after some “arm wrestling” with the Senate Committee on Ways and Means.

“I had trouble getting it included in the Senate budget because we have fairly new staff on the Senate Ways and Means Committee and they didn’t get the idea that we weren’t asking for money, we were asking for language in the law,” she said.

The Senate budget says “funds may be expended” for the new office.
Rep. Jeffrey Sanchez, serving his first term as Fargo’s co-chair, said the recession should not “distract us from the fundamental human right to access” to health care.