Health Disparities Impoverish Us All

Questions like these underscore the breadth and complexity of the challenge before us. To win the fight against health disparities, we must catalyze action in every sector and at every level.
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This April, we commemorate Minority Health Month -- and this year, an important milestone: the 30th anniversary of Secretary of Health and Human Services Margaret M. Heckler's Task Force Report on Black and Minority Health. As Secretary Heckler explained in 1985, she hoped the study would "mark the beginning of the end" of the "continuing disparity in the burden of death and illness experienced by Black and other minority Americans."

Three decades later, we've made real strides in improving the health of minorities across the lifespan. In 1981, for example, the infant mortality rate of blacks was 20 per 1,000 live black births; by 2010, it had dropped to 11.46. In 1980, life expectancy for blacks was 68.1 years; by 2010, it had grown to 75.1.

Yet despite progress, much more needs to be done to make Secretary Heckler's vision a reality. In many areas, from cardiovascular disease (CVD) to cancer, the burden of death and illness still weighs disproportionately on racial and ethnic minorities. To give just one example: For all the success in reducing black infant mortality, the Centers for Disease Control and Prevention (CDC) reports that in 2010, "the non-Hispanic black rate was 2.2 times the non-Hispanic white rate."

We cannot wait another 30 years for equity. People's lives are being diminished right now. We need to draw attention to these gaps, and to close them once and for all. That means identifying communities at risk and working together to fix what's broken -- because, in many cases, effective interventions exist; but they are not getting to the people who need them most.

As CEO of the Women's Heart Alliance, I'm focused on CVD -- a disease that claims a woman's life almost every single minute of every day. CVD can strike anyone; yet black and Hispanic women are especially vulnerable, reflecting persistent gaps in awareness, prevention, treatment and support.

For example, although almost half of black women and roughly a third of Hispanic women have CVD, two-thirds are unaware that it's the leading cause of death.

Compared to their white counterparts, black and Hispanic women have dramatically higher rates of obesity and diabetes -- two major CVD risk factors.

Fewer than half of black and Hispanic women who suffer from high blood pressure--another risk factor -- have it under control.

All these realities are intertwined with broader socioeconomic inequalities that impact and inhibit many black and Hispanic women's chances to lead healthy lives. Where can a woman learn about the risks of CVD if she doesn't have a regular health provider? How will she avoid diabetes if there is nowhere in her neighborhood to buy affordable, nutritious food? How can she stay physically fit if her streets aren't safe for walking?

Questions like these underscore the breadth and complexity of the challenge before us. To win the fight against health disparities, we must catalyze action in every sector and at every level.

First, we should make the most of the preventive opportunities we already have. According to a recent CDC survey, 87 percent of black women and 79 percent of Hispanic women have met with a health care provider during the previous 12 months. Yet in 2012, the American Heart Association found that only 22 percent of black women and 12 percent of Hispanic women reported that their doctor had ever discussed their risk of heart disease when talking with them about health.

We need to find ways to incentivize and enable health providers to take more time with patients, and to support them in offering cardiovascular screening, counseling and follow-up care, so that women have the support they need to reduce their CVD risk. And to reach the underserved, we must bolster the links between communities and the clinical care system -- through team-based care, more support for community health workers and other grassroots interventions.

We also need to support and sustain funding for government programs that work, such as CDC's WISEWOMAN, which provides heart disease and stroke risk factor screening for low-income women; HHS' Million Hearts initiative, which unites public, private and nonprofit organizations in fighting heart disease and stroke; and Federally Qualified Health Centers, which offer primary care in underserved communities. As part of that, we should fund and maintain the Public Health Prevention Fund, which invests in activities nationwide, such as prevention initiatives, including for tobacco; public health infrastructure; and public health workforce and training.

And we need to mobilize more businesses, schools, community- and faith-based organizations to spur a heart-healthy society--by raising awareness, supporting healthy lifestyles and equipping people across all demographics to live healthy, full and productive lives.

We must all do our part, because health disparities aren't just data. Behind each fact is a human face. In CDC Director Thomas R. Frieden's words, "Every person who dies young, is avoidably disabled, or is unable to function at their optimal level represents not only a personal and family tragedy but also impoverishes our communities and our country."

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