The panel consisted of five women in the field of health, health care, education and housing. Dr. Joyce Essien, Director for the Center for Public Health Practice, Rollins School of Public Health at Emory University. A large title for a large and impactful job. She bought up phrases like health equity and disparity (which we will discuss later) and showed us excerpts of the PBS Documentary Unnatural Causes. We were immediately humbled and full of thought when we heard facts like: for all the rich countries for which there is data, the U.S. has the highest infant mortality rate and African American infant mortality rates for infinitely higher than Caucasian infant mortality rates inside the U.S.
Once we had all been formally introduced to the "elephants in the room," health, health care, and more importantly, health equality does not equal available health care for all. Although, ensuring health care for all is a good step, the fact of the matter is that health equality means different solutions for men, women, of every ethnicity.
What is the highest standard of health for every person? That is the definitiion of health equity. What are we willing to do to achieve health equity? These are all questions posed by panelist, Fleda Mask Jackson, DPH, Affiliated Professor, Rollings School of Public Health. Health equality and disparity takes a looks at socio-economic implications on health and health care, and not just a broad-based outlook on what is needed. There are issues linked to African-America women that do not immediately impact Caucasian or Hispanic women, and vice-versa. Look at quality of life, depression, and stress as indicators of disease and sickness.
Renee Lewis Glover, J.D., CEO of the Atlanta Housing Authority, took a very different look at health and health care. She has spent her time stopping public housing development. How can we solve affordable housing inside of a community? What do we need to do to assist individual in achieving great outcomes? In 1996, AHA created the financial and legal model for mixed-income, mixed-finance transactions that include public-assisted housing as a component. This model is used by the U.S. Department of Housing and Urban Development's HOPE VI revitalization program. In Atlanta, it has resulted in six vibrant mixed-income communities, with three more in the predevelopment phase. The thought is that bringing the low income level families into a metro brings more opportunity to live the "American dream."
Diane Allensworth, Ph.D., Centers for Disease Control, spoke on how all the "dots" are connected. If you are in good health, you are more likely to have good academic performance, leading to college and hopefullly a career. Plus, if you are doing this for yourself, you are most likely following this for your children. With health, comes education and social responsibility. In the United States, over 7,000 students drop out of school every day! WHAT! 1.2 million by the end of the year. THere is an achievement gap. In the 1990s, the CDC goals turned to reducing health disparity. This got Allensworth more interested in school health and public health. She found that if children are not graduating, they won't be able to afford insurance or health food. Then looking at why kids are not graduating, 2/3 of low poverty kids go to high poverty, low performance schools with more teachers teaching out of credentials, the greatest teacher turnover, unsafe school and toxic environments and the resources are most limited.
Linda Blount, MPH, National Vice President, Office of Health Disparities for the American Cancer Society shared many facts with us on the state of health, education and community. Here are a few:
- Health inequities cost around $250 million/year in medical costs among low income minorities.
- 1 in 3 Hispanics is uninsured.
- 1 in 5 African Americans is uninsured.
- In terms of reform, if everyone had insurance tomorrow, we would still have health inequities.
- The lack of health insurance annually causes 18,000 infants deaths a year.
- Three reasons for the inequality in mortalities rates from the 80s: the economy began to worsen, we learned to detect/treat breast cancer. The mortality differences in cancer in women between African American and Caucasian begins to widen each year.
- Insured African American women were 7-10% less likely to get breast conserving surgery than insured Caucasian women.
I will be back tomorrow night to try and wrap up a full day of sessions on health and health care.