BY KANCHI DOSHI — Fifty years after his famous “dream” speech, Dr. Martin Luther King Jr.’s voice continues to resonate within the ears of millions who are desperate for adequate and equal health care. Studies have illustrated that differences in socioeconomic status is the most significant factor for inequalities in our healthcare system. Due to the disproportionate distribution of minorities in lower socioeconomic tiers, these health-related injustices are pervasive among those communities.
Prior to the recent policy changes, the US healthcare system focused on the end-effects of pathological states and failed to pursue approaches that prevent chronic diseases. In fact, research suggests that a strong nexus exists between poverty and obesity. The rate of obesity in America is drastically increasing as many devour fast food meals and fail to engage in physical activity. As a matter of fact, the CDC has reported that obesity costs the United States $147 billion each year, which is $50 billion more than health care costs related to treating cancer.
Interestingly, there is direct correlation between lower income communities and the inaccessibility of healthy foods options in the United States. In these communities, healthy lifestyles prove to be difficult due to a lack of fresh food supermarkets and a dominance of fast-food chains that serve high fat content and low nutrient meals. Without having access to healthy food choices, individuals cannot actively make positive and constructive decisions to change their diets. Given these conditions, it is inevitable that these communities will continue to face disparities in health outcomes. Moreover, the lack of safe neighborhoods to conduct outdoor activities and exercise, and the prevalence of drug and alcohol abuse further contribute to the disparities.
While many of these lower socioeconomic communities commonly face health hazards such as pollution, addiction, violence, and sedentary lifestyles, these are not the only contributors to the current social injustices with regards to health care. While the appalling days of the Tuskegee Syphilis Study loom in the minds of many minorities, systemic racism in public institutions as well as health provider bias continue to promote unequal health care.
In the recent wake of the new health care reform debate, the concern for these disparities has resurfaced. In addition to broadening access to health care through Medicaid expansion and instituting new requirements for employer insurance, the 2010 Patient Protection and Affordable Care Act (ACA) will increase data collection and research, enhance work distribution and diversity, and promote cultural competence education for health care providers. The ACA will also help millions of women gain guaranteed access to additional preventive services such as mammograms, screenings for cervical cancer, well-woman visits, contraception, and domestic violence screening and counseling. Most importantly, in my opinion, the ACA will allocate 10 billion in prevention measures each year through a prevention and public health investment fund. These measures include smoking cessation initiatives, building bicycle trails, increasing healthier grocery stores, and instituting more screening programs in lower socioeconomic communities.
History demonstrates that eliminating racial and social mindsets worldwide is a challenging and arduous task. Abolishing such disparities within our healthcare system, which is deeply rooted in a multifactorial and dynamic establishment, proves to be no less challenging of a task. Fortunately for us, the current administration has taken upon this mission with the implementation of the ACA and change is imminent.
