Keeping an Eye on the Prize: Healthcare for All

October 23, 2009

GCORR Commentary
By Jeneane Jones*

Former President Jimmy Carter brings up the dreaded "R" word in the debate over the Obama Administration's health care reform bill. President Barack Obama refuses to go there when describing the acerbic criticism his health care plan is receiving. His recurrent response seems to be 'this isn't about me. It's about the country.'
 
But to be clear, racism is imbedded in the health care system just as it is imbedded in the fabric of U.S. culture. Just talk to patients and health care professionals in places like Detroit, MI where chronic disease goes hand in hand with the color of your skin and income level. It is here that the role of racism in the country's broken health care system becomes tragically evident.
 
Chronic diseases are preventable illnesses like high blood pressure, asthma, and type-two diabetes. According to studies by national agencies including the Center for Disease Control, these chronic diseases reside in racial ethnic communities at a far higher rate than white communities and are far more likely to be deadly in racial ethnic communities.
 
Dr. David Law, Executive Director of the Joy-Southfield Health Education Center, a free health clinic supported through the General Commission on Religion and Race, says to make that picture personal, he needs look no further than health statistics describing his city. 59% of Detroit's population resides in federally designated medically underserved areas, compared with 33% of Michigan residents.
 
Research done by the George Washington Univ. Medical Center School of Public Health and Health Services shows the number of primary care physicians per 1000 residents in Detroit is .20 versus .76 for the state. Statistics paint a bleak picture of Detroit – with the highest rate of preventable hospitalizations for people aged 40-64 in the United States. Detroit unfortunately is not alone, and the cost is not carried by the patients alone.
 
A report by Johns Hopkins Bloomberg School of Public Health and University of Maryland researchers estimates that racial health disparities cost the U.S. $229 billion between 2003 and 2006. Here are some of those disparities:
  • Mexican-Americans are nearly twice as likely to have diabetes as whites. 
  • Vietnamese-American women have nearly five times the rate of cervical cancer as white women. 
  • Black men are twice as likely to have prostate cancer as white men.
"When you look at the burden of chronic disease, when it's not managed, the patient is sicker and dies younger," says Dr. Law. "That can happen to anyone but it happens disproportionately to families of color and low income families. In this country, your lifespan and quality of life is determined in part by your race and your ethnicity."
 
While racial inequality is a key factor in telling the story of healthcare in the U.S., Dr. Law says at his center it's not a key focus. "We're not trying to teach about racial health inequities, we're trying to remove them by giving people access to quality health care."
 
Joy-Southfield Health Education Center is one of the recipients of the General Commission on Religion and Race CORR Action Fund. The fund is one way the United Methodist Church invests in churches and community organizations working to dismantle racism. The Joy-Southfield Center has been receiving funds from the United Methodist Church since 2001 and has seen its capacity grow to more than three thousand free clinic visits annually.
 
"We are a safety net for those without health insurance in the city," says Dr. Law. "We're a free clinic designed to give quality health care to those who can't afford to pay monthly insurance premiums. When health care reform comes, our goal will be to go out of business as a free clinic, but realistically that's not going to happen soon."
 
People like 61-year-old Gaynella Green consider Joy-Southfield a lifeline. When she lost her job, Gaynella's high blood pressure and diabetes got out of control. She went to the center for help. The staff responded with a mixture of low tech and high tech interventions. "We nurture relationships with patients." Doctors at the clinic, all of whom work pro bono, spent time talking with Gaynella about ways to handle stress. They provided her with free medicine, ideas for eating better and exercising. A new telehealth program using computer software lets patients manage their progress online. All of this helped turn Green's life around. "Every person is treated special here, as if they had a million dollars' worth of insurance," said Green.
 
Dr. Law says the way he sees it, Joy-Southfield is health care reform on a small scale. "We've proved that you can start small and do well. We give our patients respect, and nurture long-term partnerships. That doesn't cost anything except a willingness to spend more time with patients. We develop relationships that empower clients with knowledge and resources. This can be replicated. You go into a community and ask residents what they need. Find some common ground, then start to work."
 
President Obama and Joy-Southfield may be working from the pages of the same playbook. Don't become distracted with side arguments. Don't take your eye off the prize. In this case, the idea is to provide everyone equally, a right to quality health care and good health.
 
*Jones is assistant chief executive over media relations for the United Methodist Commission on Religion and Race. She was Director of Communications for the California-Nevada Annual Conference before accepting the GCORR position.