Year after year, health care for Black Americans grows increasingly perilous. On nearly all of the life-threatening ailments and diseases, the plight of African-Americans continues to top the charts. For example, according to Blackhealthcare.com, the prevalence of diabetes among African-Americans is 70 percent higher than among white Americans. Infant mortality rates are twice as high for African-Americans than for white Americans, and there continues to be a wide disparity between Black and white Americans when it comes to the survival rate of cancer patients.
Black Americans also top the list when it comes to AIDS, asthma, heart disease, hypertension, sickle cell anemia and strokes.
Moreover, a recent study by the National Center for Health Statistics revealed that non-Hispanic Black and Mexican-American women had the highest rates of obesity—about half of whom were obese in their 40s and 50s. In contrast, the study says, 39 percent of non-Hispanic white women were obese at the same age.
As Black women get older, the study shows, their rates increased again. Sixty-one percent of Black women 60 or older were obese, compared with 32 percent of Mexican-American women, according to the study.
Implementing solutions to eliminate health disparities in New York’s Black and Hispanic communities was the subject of the Empire State Medical Association’s Second Annual State Conference, held Nov. 3, 2007, at The New York Academy of Medicine in New York City. The association is the New York affiliate of the National Medical Association, an advocacy group for Black physicians. Addressing the conference, state health commissioner Richard Daines, M.D., said New York’s “Health Care Reform Agenda” seeks to achieve universal coverage by trying to enroll all who are eligible to be enrolled, expanding the Child Health Plus program and working closely with the state legislature.
Because universal coverage alone will not stop health care disparities, he said, the state is addressing the quality of health care by creating a patient-centered system and improving primary care with a consistent medical home. Increasing minority physicians and reducing workplace discrimination is a priority of the agenda, he said.
Commenting on disparities that exist in the incidences of diabetes and obesity, Shadi Chamany, M.D., director of the N.Y.C. Department of Health, said the department recommends establishing a healthy diet, increasing physical activity and maintaining a healthy weight. She said policies include trans fat and calorie labeling, day-care guidelines specifying types of food that should be available, including water, less than six ounces of juice and 1-percent-fat milk after age 2. Caloric labeling has been proven to positively modulate people to choose healthier foods. Other policies are:
• A bodega initiative promoting healthier food choices and moving to 1-percent milk, fruits and vegetables.
• “Health Bucks” coupons that shave $2 off the price of fruit and vegetables.
• “Shape Up New York” program of free activity classes at parks and recreation centers.
• Promoting school wellness councils.
• A registry for HgbA1c (the percentage of hemoglobin molecules that contain glucose) to help patients better understand tight control of their sugar and identify those with high levels for supplemental intervention.
Healthy eating, healthy living
John Palmer, M.D., executive director of New York City’s Harlem Hospital Center and Renaissance Health Care Network Diagnostic and Treatment Center, has been promoting a “Healthy Eating, Healthy Living” initiative for several months, and he believes that a diet of healthy foods can reverse many chronic illnesses, particularly heart disease. “Eat a lot of vegetables and minimally processed foods, and avoid all things greasy,” he said in a recent interview.
The doctor also stresses a regimen of daily exercise to improve the cardiovascular system. When it is not possible to get to the gym or the park, running in place in the bedroom and isometrics are beneficial exercise options. And he is pleased that at least in New York City the restaurants are dutifully observing the ban on trans-fat cooking. The more solid the fat, the more it clogs our arteries.
Dr. Palmer said there are more than 20 million Americans with diabetes, but nearly one in three does not know it. He recommends annually screening and testing, and this is particularly important for African- Americans, Latinos, Native-Americans, Asian-Americans and Pacific Islanders who are more at risk.
“Eat a lot of vegetables and minimally processed foods, and avoid all things greasy.”
—John Palmer, M.D.
But the path toward healthy living begins with healthy eating and here are a few suggestions, based on a survey of several Web sites promoting a balanced diet packed with the vital nutrients:
Rather than that customary power bar, try a single-size carton of low-fat chocolate milk. Instead of a Caesar salad for lunch, why not a chicken sandwich on whole-grain bread? For breakfast, feast on a low-fat or fat-free yogurt parfait. And if you must have dessert, munch on a slice of melon or some other fruit.
This will not be an easy alternative for those used to a daily hit of buffalo wings. Remember, however, that you are what you eat. And who wants to be a buffalo?