Despite the fact that the United States spends more on health care than any other industrialized nation, significant health disparities persist among various racial, ethnic, and socioeconomic minority groups, according to the Centers for Disease Control and Prevention.
Consider the following CDC statistics:
- African-Americans are almost twice as likely to be diagnosed with diabetes as non-Hispanic whites, and they are more likely to suffer from end-stage renal disease, lower extremity amputations and complications from diabetes.
- Native Americans (American Indians and Alaska Natives) have a greater chance of having diabetes than any other U.S. racial group.
- Approximately 52 percent of Hispanics and 42 percent of African-Americans age 50 or older said they never had a sigmoidoscopy or colonoscopy screening test for colorectal cancer, compared to 36 percent of older white adults.
- In 2014 the infant mortality rate for non-Hispanic black infants was more than twice the rate for non-Hispanic white infants.
That’s a sampling of the data highlighting the scope of this dilemma.
To help eliminate these health disparities, April has been designated National Minority Health Month with the goal to “strengthen the capacity of local communities to eliminate the disproportionate burden of premature death and preventable illness in minority populations through prevention, early detection, and control of disease complications.”
Reflecting this objective, the theme for this year’s Minority Health Month is “Bridging Health Equity Across Communities.”
Dr. Lawrence Monger of University of Toledo Physicians applauds the establishment of Minority Health Month. “There have been a lot of disparities in minority health over the years, and I think it’s a wonderful thing to make people more aware of what they may be missing or lacking in their health care that could have major repercussions down the road,” Monger said.
As an internal medicine physician, Monger is no stranger to the issue of minority health disparities. One he regularly encounters in his office is reduced access to colon cancer screening for African-Americans. He says many patients and doctors are unaware that the latest recommendations for colon cancer screening are different for African-Americans.
“All national recommendations state that African-Americans should begin colon cancer screening at age 45, which is five years earlier than the recommendation for other groups,” Monger said.
Unfortunately, this current recommendation also is unfamiliar to many insurers, who may refuse payment for screenings that they believe have been performed prematurely.
Another major disparity Monger observes is in the realm of prostate cancer screening. As with colon cancer screening, it is recommended that African-American men begin getting screened for prostate cancer at age 45—five years earlier than other groups—because research shows they tend to die earlier from the disease, and their prostate cancer is usually more advanced at the time of diagnosis.
Monger points out that among the factors contributing to these particular health screening disparities is the natural reluctance men often have to undergoing the screening tests themselves. “Many men understandably shy away from getting a colonoscopy or rectal exam, but it’s so important to start these screenings in a timely manner,” Monger said. “Education is our best tool in overcoming this reluctance.”
Identifying a health disparity is only half the equation. The other half is taking the necessary steps to eliminate it. According to Monger, an important part of the solution is encouraging people to establish a relationship with a primary care physician and follow through with routine medical checkups. “Too many patients—especially men—are coming to my office with health issues much later than they should,” Monger said. “Don’t wait until you have a medical problem to go see your doctor. Instead, you should go when you’re healthy, not only to establish that vital rapport, but also so you can start working together to map out a plan for your ongoing health care.”
Nurturing a relationship with a primary care physician also ensures that your unique medical and family histories are well documented, which can have a significant influence on how your treatment is tailored as well as on the timing of health screenings. Over time, he or she also will develop an understanding of your lifestyle, the community in which you live and work, and a variety of other factors that might influence the big picture of your health.
To help reach more individuals who may be medically underserved, Monger does a lot of word-of-mouth outreach. He asks patients whether they have any family members who aren’t getting regular medical evaluations and may need to be seen. By ensuring their loved ones get the ongoing care they need, every family member can be part of the solution to health disparities.
“As an internal medicine physician, I’m here and available to treat adult patients. I would love to be your doctor,” Monger said.❦