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Wednesday, June 25, 2008

Health Care’s Racial Gap

African Americans face medical disparities

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Juneteenth 2008 celebrated, as it always does, the day in 1865 on which slaves in Texas learned that they had been emancipated. But this year’s Juneteenth celebration also was a day of action for Milwaukee’s African-American residents and health care professionals who want the next president and elected officials to address the wide racial disparities in health care.

Service Employees International Union (SEIU), Healthcare United and their allies were at the Juneteenth gathering on June 19, where they registered voters and urged Milwaukeeans to make health care an important electoral issue. “We have to actively engage in the political process,” said Clarene Anderson of the Black Health Coalition of Wisconsin. “We have to force the change that needs to occur.”

Before the event, national SEIU representatives stopped in Milwaukee as part of a national “Road to Health Care” bus tour aimed at drawing attention to how members of racial and ethnic minorities are disproportionately disadvantaged by America’s broken health care system.

Minorities make up half of America’s 47 million uninsured, and health issues such as cancer, diabetes, asthma and low-birth-weight infants are especially challenging for African Americans. Yet having insurance doesn’t mean that African Americans receive medical care that is on par with that of whites. The SEIU’s newest report on health care found that whites receive higher-quality treatment than African Americans with the same income level and health insurance coverage.

These factors create poorer health outcomes for illnesses such as diabetes (diabetic African Americans are more likely to have a limb amputated), asthma (African Americans are more than three times as likely to die of it than whites) and cancer (African Americans are more likely than whites to die after diagnosis).

Alicia Treadwell, an African-American home health care worker in Milwaukee who is uninsured and faced massive medical bills after falling on ice this winter, said African Americans put off seeing a doctor until it’s too late. “By the time we leave the doctor we have to make funeral arrangements,” Treadwell said.

Solutions
SEIU and its allies are pushing for a “new health care system for everyone,” said Dian Palmer, president of SEIU Local 1199 Wisconsin. Universal health care coverage, such as the Senate Democrats’ Healthy Wisconsin plan, will “absolutely” be introduced again next year, promised state Sen. Spencer Coggs (D-Milwaukee).

He said that the expansion of BadgerCare has been “key and crucial” to providing health care for kids, but that universal coverage would help uninsured workers such as Treadwell who can’t afford health insurance independently.

But Milwaukee’s African-American community faces barriers to health care that go beyond insurance. The health care infrastructure of central Milwaukee, which had thrived prior to the 1980s, has turned into a medical wasteland.

Health clinics, doctor’s offices and hospitals are lacking in the predominantly African-American North and Northwest Sides of Milwaukee, since the large hospital chains have preferred to expand in the suburban areas, where doctors can compete for wealthy—and predominantly white—patients.

Coggs said that community health clinics, such as the expanding Isaac Coggs Heritage Health Center, are serving more Milwaukeeans than they can handle. “These residents need more access to health care,” Coggs said. Perry Margoles, who runs the Milwaukee Immediate Care Center, 1971 W. Capitol Drive, said his clinic has survived because it draws clients from the neighborhood and the rest of the county who want quality, affordable health care in a convenient location. Margoles said only a fraction of African Americans in the city use Medicaid or BadgerCare; the vast majority has insurance and does not go to community clinics.

The clinic’s nonprofit business model was studied and refined over a number of years, Margoles said, and patient revenues account for 85%-90% of the clinic’s operating revenues. It combines primary care and urgent care, and has extended hours (8 a.m.-11 p.m. Monday-Saturday; 10 a.m.- 9 p.m. on Sunday) and a reasonable per-visit fee of $75. The clinic provides free blood-pressure checks, which Margoles estimates averts eight to 10 heart attacks and strokes a month. Margoles said he wants the clinic’s doctors and staff to take time with each patient to assess his or her unaddressed health concerns, such as diabetes or high blood pressure, in addition to colds and flu, for example.

Margoles said this can be a costly way to treat patients, but it pays off by enhancing a client’s long-term health and well-being. “I want our doctors to practice good health care, to take their time with each patient and not to compromise their care,” Margoles said.

What’s your take? Write: editor@shepex.com or comment on this story online at
www.expressmilwaukee.com.

Photo: Patrick Flaherty, Wisconsin coordinator for Healthcare United; and Bill Martin, home health care worker, registering voters at Milwaukee's Juneteenth celebration

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