Ethnic Healthcare Disparities and Economics

A variety of factors cause the disparity in healthcare among ethnic groups in the United States, said J. R. Murray, ’85, managing director of Pan American Risk Management Associates, LLC. Among those causes are under-insurance, environmental influences by geography, historically reactive rather than preventive government policies, and unrepresentative samples of the public in testing of pharmaceuticals, Murray said at the 23rd Annual DuSable Conference, presented by the student-led African American MBA Association at Palmer House Hilton November 9.

“The pharmaceutical therapies that have been developed for many diseases, including hypertension, congestive heart failure, and various types of cancers, were tested on a small subset of the population,” he said. “Often times they were not tested on the elderly, Hispanic Americans, and African Americans. We’re seeing evidence now that many times these therapies aren’t as effective among some people.”

The causes of disparity vary by ethnic group, said Dr. Adam Murphy, surgery resident at Northwestern University. For example, 20 percent of Hispanic Americans bring an interpreter because they have difficulty communicating with their physicians, Murphy said. “If you can’t really have an effective dialogue with your physician, that means you get under-treated,” he said.

Of 29 million African Americans with health insurance, 12 million are covered by publicly funded programs such as Medicare, Medicaid, and the Veterans Administration, Murphy said. “People would argue that a lot of those programs don’t give you the flexibility or continuity of physician care that other programs would,” he said. “Even when you are insured, a lot of physicians do not stay very long in areas serving African Americans.”

In the short term business and policy leaders should attack the disparity in healthcare in at least five different ways, Murray said. “If you looked at it as a war, you’ve got to fight it on several fronts and in several theaters,” he said.

Those five fronts include encouraging public programs to “pay for performance” in certain zip codes, educating providers about cultural and medical differences among the public, advocating for access to available treatments regardless of cost, creating incentives for employees to engage in healthy behavior, and addressing the obesity epidemic from many angles, Murray said.

Data collection is extremely important to address the disparity in medical research among minority groups, Murphy said. “Some people liken this to what should be a civil rights cause,” he said. “A 10-year difference in life expectancy between the average black man and average white man is tantamount, to me, to being able to go to the same schools and ride on the same buses. I want my 10 years.”

The African American MBA Association assembled a panel on healthcare because it is one of three pressing issues facing African Americans today, said second-year student Thomas Davenport, chairman of the conference. “Personally, I learned a ton about healthcare,” Davenport said. “Hearing a doctor’s perspective, I discovered he really wishes patients would push back a little more. I think people are more afraid of the doctor, because he is the expert on questioning what are the alternatives, what are other treatments that are available. That was refreshing to hear.”

- Phil Rockrohr