Racial and Cultural Disparities in Health Care and Health Outcomes
Speech by Wade Henderson at Facing the Future, Baltimore Convention Center, on September 14, 2001.
New Directions on Perinatal Care, 4th Annual Conference: Racial and Cultural Disparities in Health Care and Health Outcomes
Good afternoon, I am Wade Henderson, Executive Director of the Leadership Conference on Civil Rights (LCCR). The Leadership Conference is the nation's oldest and most diverse coalition of civil rights organizations. Founded in 1950 by Arnold Aronson, A. Philip Randolph and Roy Wilkins, LCCR works in support of policies that further the goal of equality under law. To that end, we promote the passage of, and monitor the implementation of, the nation=s landmark civil rights laws. Today the LCCR consists of over 180 organizations representing persons of color, women, children, organized labor, persons with disabilities, the elderly, gays and lesbians, and major religious groups. For a more detailed description of the Leadership Conference's advocacy and research work and its constituent and partner organizations, I encourage you to visit our website at www.civilrights.org.
I am pleased to appear at this conference on behalf of the Leadership Conference and privileged to represent the civil rights and human rights community in addressing you today. I'd like to thank you for your attention to the very important issues of minority health and the continuing racial and ethnic disparities in both the access to health care and health care outcomes.
It was my intention to focus my remarks today on two examples of current health care disparities and how they relate to and illustrate broader societal civil rights concerns. Before I begin, however, let me use a few minutes of the extra time we have because of the absence of my friend Lynn Huntley. Lynn was unable to travel here from Atlanta because of the tragic events of this week. While no words here can adequately express the overwhelming sense of sadness, disbelief, fear and outrage brought on by Tuesday's acts of terrorism, I know that Lynn would have eloquently made the point that this week's events highlight the importance of the issues we are here to discuss and remind us of the urgency of solving the festering problems of social injustice and inequality.
While we keep the victims of this tragedy in our thoughts and our prayers, there has been much talk about refusing to bow to terrorism or allow the terrorists to change our way of life or take away our cherished American freedoms. Far more important than the debates about whether and when to resume sporting events or reopen financial markets, preserving our way of life means protecting our most important civil and constitutional rights. It is crucial to remember as we mourn and in the days ahead when the United States may respond with military attacks, that these acts, while they were attacks against all of America, were attacks committed by individual terrorists, not by Arabs as a whole, nor by Muslims. Already, there have been reports of gunfire directed at mosques in Texas and Seattle and death threats against the children at an Islamic school in New York City. At this most difficult time, the best measure of whether we have preserved our American way of life will be our vigilance in protecting the individual rights of the countless millions of Arabs and Muslims who as Americans and members of the world community have been victimized by this attack just as all of us have.
I hope that a copy of Lynn's speech has been included in your materials and I strongly recommend it to you. To paraphrase her words, we live in a world full of suffering, misunderstanding, division and gross inequality and we have just experienced the most extreme proof that desperate people will lash out and commit desperate acts of senseless vengeance to draw attention to themselves and their causes.
Lynn also wanted to make the point that our notion of Arace@ is a human construct with far less medical and genetic meaning than people commonly believe. While she is undoubtably correct, the arbitrary walls we humans have constructed around physical traits like skin color, facial features and the texture of our hair to define race create very real, practical and dangerous divisions within our society, just as surely as they have contributed to the dangerous divisions between nations. Until we bridge these divisions at home, it is difficult to believe we can successfully address them abroad.
So, how do we address racial disparities in health care as we move forward into the 21st century? To start, we must recognize the reality of our present situation and be willing to openly address the fact that race and racial discrimination still play powerful roles in health care. While socioeconomic disparities, like poverty and the differences between urban, suburban and rural communities, are significant and often exasperate existing racial disparities, attempts to focus on them to the exclusion of race amount to hiding from the problem.
Even after controlling for socioeconomic factors, there are still persistent differences across racial lines in the access to health care, the quality and nature of care available and even, as a recent study demonstrated, the actual diagnostic and treatment decisions made when patients of different races present with identical symptoms. There are also persistent racial disparities in the design and conduct of clinical research, as well as in cultural and language barriers and environmental health hazards. In one crucial area where we are in danger of slipping backwards, the barrage of court and legislative assaults on affirmative action in education are threatening to erase recent gains in the recruitment and training of minority doctors who are more likely to serve the health needs of minorities and the poor.
Another part of recognizing reality, however, is to acknowledge the progress we have made, particularly over the last three years. Dr. Mighty discussed some of the progress made here in Maryland. I=d like to add to that some significant steps taken on the national level. In 1998, as an outgrowth of the President=s Initiative on Race, the Administration announced an ambitious program to eliminate the racial disparities in six specific and clearly measurable health fields: infant mortality, cancer screening and management, cardiovascular disease, diabetes, HIV infection and immunization. Those goals are reflected in Health People 2010, which also took the important symbolic step of stopping the practice of setting separate, lower standards for health outcomes in minority communities. Another significant accomplishment was the passage last year of the Minority Health and Health Disparities Research and Education Act of 2000, which created the new National Center on Minority Health and Health Disparities at the National Institutes of Health. A very important step forward in promoting clinical research, medical education and public education on health disparity issues.
Even here, I feel compelled to note that these crucial but basic steps forward were not taken without significant resistance. Incredibly, the legislative process which brought forward the Minority Health Act was fought by the opponents of affirmative action, who claimed that it was unconstitutional for the government to target resources toward particular health problems because the burden of those problems falls more heavily on minorities or women. Even today=s courts, too many of which appear willing to discount important facts like the high percentage of minority professionals who return to work in underserved communities, would be unlikely to tolerate the extreme arguments advanced by the political foes of addressing racial health disparities. Still, it is sad to note that in order to pass the bill, the first and most promi
