The Common Good

America's Pervasive Pattern of Race-Based Medical Disparities

Our country has a long history of underserving and mistreating African-Americans and other marginalized groups. We are seeing this history come to a head in cases such as the 2007 death of a twelve-year-old African-American child, Deamonte Driver of Prince George's County. Driver died because his mother could not find a Medicaid dentist who would see him for an infected tooth.

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Sadly, Driver's death is one example of many in which, from its inception, America's health-care system has treated African-Americans unjustly. Although I am specifically addressing disparities in the health-care system for African-Americans, the issue of health care affects Americans of all races and economic backgrounds. It is my hope that by examining health-care injustice in the African-American community, we can see the need for universal health care for all.

Instances such as the Tuskegee Experiment point to the inequality of the American health-care system:

For forty years between 1932 and 1972, the U.S. Public Health Service (PHS) conducted an experiment on 399 black men in the late stages of syphilis. These men, for the most part illiterate sharecroppers from one of the poorest counties in Alabama, were never told what disease they were suffering from or of its seriousness. Informed that they were being treated for "bad blood," their doctors had no intention of curing them of syphilis at all.

The data for the experiment was to be collected from autopsies of the men, and they were thus deliberately left to degenerate under the ravages of tertiary syphilis -- which can include tumors, heart disease, paralysis, blindness, insanity, and death. "As I see it," one of the doctors involved explained, "we have no further interest in these patients until they die.

The true nature of the experiment had to be kept from the subjects to ensure their cooperation. The sharecroppers' grossly disadvantaged lot in life made them easy to manipulate. Pleased at the prospect of free medical care -- almost none of them had ever seen a doctor before -- these men became the pawns in what James Jones, author of the excellent history on the subject, Bad Blood, identified as "the longest non-therapeutic experiment on human beings in medical history."

When the experiment was brought to the attention of the media in 1972, news anchor Harry Reasoner described it as an experiment that "used human beings as laboratory animals in a long and inefficient study of how long it takes syphilis to kill someone." (by Borgna Brunner)

Today, African-Americans have higher rates of heart disease, diabetes, and high blood-pressure; new research is showing that the high levels of these diseases in the African-American community may be due to the stress of living in a racist society. Environmental racism has led to a great amount of inner-city African-American youth being plagued with asthma. The life expectancy for African-Americans is much lower than that of whites (Mortality of White Americans, African Americans, and Canadians: The Causes and Consequences for Health of Welfare State Institutions and Policies, by Kunitz SJ and Pesis-Katz I.). Although all American citizens are harmed by our current health-care system, African-Americans are harmed at alarming rates, shown by the fact that "for many health conditions, non-Hispanic blacks bear a disproportionate burden of disease, injury, death, and disability." (CDC-MMRW Weekly)

Our quality of life is affected by a health-care system that was not created for us, but has used us to benefit others. Ever since we were seen as three-fifths of a human being during slavery, our bodies were used in gruesome experiments by doctors who wanted to perfect their craft, at our expense, so that they could better serve white society. Harriet A. Washington shines a light on how harmful the American field of health care has been to African-Americans in her landmark book, Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present. African-Americans who were enslaved, or free but poor, were at the mercy of a health-care system that gave them sub-par or even harmful "treatment."

Today this inequality in health care, though not as blatant, still exists. African-Americans who cannot afford the high cost of private health care are given sub-par treatment at clinics that are overcrowded and understaffed, if they can even obtain care at all.

On Saturday Nov. 7, 2009 the house passed what President Obama praised as a "historic vote to pass a bill that would be the biggest expansion of health-care coverage since Medicare was created more than 40 years ago. The Affordable Health Care for America Act, or H.R. 3962, restricts insurance companies from denying coverage to anyone with a pre-existing condition or charging higher premiums based on gender or medical history. It also provides federal subsidies to those who cannot afford health insurance. And it guarantees coverage for 96 percent of Americans, according to the nonpartisan Congressional Budget Office."

Though this is a historic step in the right direction, the Senate has yet to vote on the bill. Even if they approve it, the single payer option was removed, meaning that the bill may not go far enough in ending health-care disparities. To ensure that African-Americans and all residents of our country (documented or not) receive health-care equality we need to continue to advocate for a single payer option where everyone is in and no one is out.

The faith community has to stand up and say -- enough! In the same way that we mobilized for civil rights, we have to mobilize for the right to be healthy. A healthy people is a strong people and a strong people can fight for equality.

This article is in memory of the late Marilyn Clement, founder of Healthcare-Now and friend of Union Theological Seminary.

portrait-onleilove-alstonOnleilove Alston is a student at Union Theological Seminary and Columbia University School of Social Work. She organizes with NY Faith & Justice and the Poverty Initiative. During the summer of 2008 she served at Sojourners as a Beatitudes Society Fellow. You can visit her blog Esther's Call.

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