Business

Racial health disparities costing NC

North Carolina lost a quiet legend last month when Dr. Alvin Blount died at age 94.

The Raleigh native earned a bachelor’s degree at N.C. A&T and went on to serve as chief of surgery for a M.A.S.H. unit during the Korean War, distinguishing himself as the only black doctor on the teams later made famous by the 1970s TV show.

When he came back home to Greensboro, however, he was only allowed to admit patients and practice in the hospital designated for black patients. He ultimately joined a small group of plaintiffs in a federal lawsuit that succeeded in desegregating hospitals throughout the Southeast.

That landmark court ruling in 1963 helped make the best medical facilities and technologies available to everyone – and demonstrated leadership by North Carolinians that continues today in tackling glaring health disparities. But more than a half-century later, minority groups are still on the wrong side of many alarming gaps in health care.

“Black Man in a White Coat: A Doctor’s Reflections on Race and Medicine,” the 2015 best-selling book by Damon Tweedy, spells them out. Tweedy, who graduated from Duke Medical School and now serves as assistant professor of psychiatry at Duke Medical Center, notes that blacks are 50 percent more likely than whites to be obese. Hypertension is 50 percent more common in blacks than whites, significantly raising the risk of strokes and kidney failure. Rates of teen pregnancy and premature births are far more common among African Americans.

Statistics from the Centers for Disease Control reflect significant disparities as well among other minority groups, including Hispanics and Native Americans.

These discrepancies are rooted in a complex web of factors. Lower socio-economic status looms large, while genetics and lifestyle choices are also involved. As Tweedy makes clear in his book, systemic issues that make it challenging for minorities to obtain adequate health care have perhaps the most negative impact at all.

Lack of health insurance and access to healthy food are among these barriers. So are limited opportunities for early detection of diseases, problems with finding transportation to medical clinics when problems do arise, and unconscious biases on the part of medical professionals that sometimes lead minorities to receive different treatment than white patients.

In addition to the human cost, researchers have estimated that racial health disparities cost our state more than $500 million annually in rising health insurance premiums and lowered worker productivity, making it harder to compete in a global economy.

And that is despite the fact that our state has long been on the cutting edge of tackling health disparities, which first entered the national conversation with the Heckler Report in 1985. By that point, UNC-Chapel Hill had already been running its Minority Health Conference for eight years. That event is still going strong – with the 38th annual conference, organized by the university’s Minority Student Caucus and Gillings School of Global Public Health, scheduled for Feb. 24. UNC’s Minority Health Project has also been influential, becoming a national leader in best practices for minority health research after its launch in 1994.

Other state universities have since helped sustain our state’s leadership in this arena. UNC-Greensboro’s School of Nursing, for example, has received millions of dollars in federal funding to study and devise solutions for minority health disparities in central North Carolina, with a recent focus on preventing risky sexual behaviors among black teen girls and improving management of diabetes among Latinos. UNC-Charlotte and Blue Cross Blue Shield of North Carolina are partnering on health risk screenings and exercise programs in cooperation with Bethesda Health Center, a clinic that serves Hispanics in north Charlotte.

In an especially ambitious effort, UNC-Chapel Hill and Greensboro’s Cone Health have teamed with the National Cancer Institute, the University of Pittsburgh Medical Center and other partners on the Accountability for Cancer Care through Undoing Racism and Equity (ACCURE) project. It focuses on creating parity in medical treatment for blacks and whites with lung cancer and breast cancer.

Intensive evaluations of many of the initiatives across the state are under way and a larger portfolio of best practices for shrinking disparities and creating greater equity in treatment is coming, says Cornell Wright, executive director of the N.C. Office of Minority Health and Health Disparities. This much is clear already: more partnerships of the kind that North Carolina has pioneered nationally will be critical for progress. “The only way this work is going to get done,” Wright says, “is if we’re doing it together.”

Christopher Gergen is CEO of Forward Impact, a fellow in Innovation and Entrepreneurship at Duke University, and author of Life Entrepreneurs: Ordinary People Creating Extraordinary Lives. Stephen Martin is deputy chief of staff at the nonprofit Center for Creative Leadership in Greensboro. They can be reached at authors@bullcityforward.org and followed on Twitter through @cgergen.

  Comments