We are all born with a lifetime guarantee, except that as Americans it is worth less for people of color than for the white population. People of color live shorter lives by as much as six years.
When we compare the life expectancies for different races and ethnicities, we see that some Americans are expected to die younger than people from some developing countries. We have known this fact for nearly 30 years, and this inequity continues to be documented annually by the Agency for Healthcare Research and Quality (AHRQ) as mandated by Congress. Some of this increased mortality is due to lack of health insurance that results in 22,000 avoidable deaths a year in the United States. However these disparities exist despite insurance coverage, and seem to persist even when there is a single payer health care system as in Europe.
Former Surgeon General David Satcher estimated that some 83,000 deaths could be prevented each year if the Black-White mortality gap could be eliminated. Unfortunately this mortality gap is increasing. For example, racial and ethnic groups have higher disease rates—notably for cancer, vaccinations, tuberculosis, sexually transmitted diseases, and chronic diseases such as arthritis and diabetes. In addition, although racial and ethnic groups tend to have higher hospitalization rates, they tend to receive less and poorer hospital treatment and less nursing home care. Additionally, research has identified that racial and ethnic groups are disabled for a greater portion of their shorter life expectancies, and are likely to experience higher levels of pain while dying. The dementia pandemic looming upon us will also affect ethnically diverse older adults more than for the general population. Studies undertaken with Ramone Valle at SDSU have shown how the increase prevalence of dementia among the Latino population in San Diego and Imperial counties will mushroom over the next 30-40 years.
The Institute of Medicine (IOM) called these disparities a “quality chasm.” This is not an easy topic to discuss. Disparities in health and health care point to systemic weaknesses in our public health system. When life expectancy starts to diminish for the first time in the history of our country, the effects are felt not just by racial and ethnic groups, but by all Americans. Based on self-reported illnesses and biological markers, U.S. residents are less healthy than their English counterparts. Here, too, the gap between U.S. health and that of other countries is becoming wider. Despite being the most lavish health care spender, the United States is falling farther behind other industrialized countries in overall health outcomes.
Improving public health systems for all older adults, and increasing access to services not only improves the health of ethnically diverse populations, but it also improves the overall well-being of our society. Today’s older adults will set a precedent for how the next generation of older adults will be treated. We have an obligation to talk about our health concerns, and to seek support from existing systems in order to stop the cycle of inequity for subsequent generations.
Mario Garrett is a professor of Gerontology at San Diego State University can be reached at mariusgarrett@yahoo.com
Dave Baldridge, is the Director, National Indian Project Center, Albuquerque, NM can be reached at dave@nipcinfo.com
© Mario Garrett 2010
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