Health Disparities and a Call for Health Justice: Black Health Matter

The CDC Health Disparities & Inequalities Report, last published in 2013, provides much of the data on disparities within the United States.  Three of the most stark findings from the report  include:

• “Cardiovascular disease is the leading cause of death in the United States. Non-Hispanic black adults are at least 50% more likely to die of heart disease or stroke prematurely (i.e., before age 75 years) than their non-Hispanic white counterparts (5).
• The prevalence of adult diabetes is higher among Hispanics, non-Hispanic blacks, and those of other or mixed races than among Asians and non-Hispanic whites. Prevalence is also higher among adults without college degrees and those with lower household incomes (6).
• The infant mortality rate for non-Hispanic blacks is more than double the rate for non-Hispanic whites. Rates also vary geographically, with higher rates in the South and Midwest than in other parts of the country (7).”

The findings of the report are echoed in study after study, report after report, year after year.  The health and lives of Black Americans were, are and continue to be at risk, sacrificed to the inattention, lack of empathy and bias of their neighbors and fellow citizens.

The Irish poet William Butler Yeats wrote:

“Too long a sacrifice
Can make a stone of the heart.
O when may it suffice?”

As doctors, we are challenged to ask ourselves: has the daily sacrifice of Black lives, of Black health, studied and analyzed and reported and discussed in healthcare and our profession, year after year, made stone of our hearts, and rendered them unable to truly understand and empathize with the pain and suffering all too many Black people are asked to endure daily?

Hasn’t that sacrifice, never warranted to begin with, and unjustly imposed, sufficed a million times over?

What have we done, as a profession dedicated to service of patients and communities, to build a society and healthcare system, informed by understanding and empathy, and dedicated to true equality of treatment and access to resources?   Especially for people and communities of color? Can we, must we do more?

The great jurist Oliver Wendell Holmes Jr., a Civil War veteran, in an 1884 Memorial Day speech, reflecting on the experience and losses of his generation in the crucible of that terrible war, recalled how “through our great good fortune, in our youth our hearts were touched with fire”.  That fire led his young generation to understand that “it was given to us to learn at the outset that life is a profound and passionate thing.” Early in our lives, through great, good fortune, as we came to profession of Medicine, we all can recount how our hearts too were touched with fire, by the insight that life, and health that allows that life to be lived at its fullest, is a profound and passionate thing.  And that our calling, dedicated to helping all in our care, heal and achieve health, was special.

It is time to rekindle that fire, reignite the caring and empathy that a heart of stone can never render, and work to end the national tragedy that daily sacrifices Black lives and health to injustice and prejudice, and finally bring the day where reporting on disparities of health in America is a thing of the past.