The Pennsylvania Legislative Black Caucus hosted a hearing on health disparities affecting African-Americans at Einstein Medical Center on Wednesday afternoon.
The meeting was one of a series held across the state on House Democrats’ Plan4PA effort, which is focused on jobs, healthcare access, quality schools and jobs training.
“At a time when health care technology is advancing at exponential rates, people should not be dying from not having the medicine they need,” said State Rep. Stephen Kinsey, D-201. “It’s important that we work together to overcome to eliminate disparities and make sure that regardless of where people live or how much money they make, that they’ll have quality access to health care. Ultimately, it will strengthen our communities and workforce.”
The hearing included testimony from doctors, nurses, advocates and public health experts who presented glaring statistics on how Black and Latino people, especially those in underserved communities, have worse health outcomes than whites.
“African-Americans in general have a higher incidence of overall cancer. African-American women have a higher incidence of breast cancer death. African-American men have a higher incidence of hypertension,” said Dr. Theodore A. Christopher, immediate past president of the Pennsylvania Medical Society.
Christopher continued that living in a poor neighborhood contributes to and compounds these issues for several reasons including that “really healthy foods are not there,” and schools are generally underfunded. Then, stating that “Zip codes matter,” Christopher observed that the average life expectancy for a person that lives in Center City is 88 years old, but for one that resides in North Philadelphia, it is 68 years old.
“The answers are not easy. It needs focused attention for a long period of time. It needs hospitals, insurance companies…We need to change how we approach this,” he said, near the end of his testimony. “A lot of people in healthcare think it’s a job of others.”
Dr. Rohit Gulati, Executive Vice President and Chief Medical Officer of Einstein Healthcare Network, discussed lack of access, poverty and trauma.
“Race and poverty contribute to outcomes,” he said. “It’s mental trauma, physical trauma, daily trauma…no food, poverty, verbal abuse. If you’re constantly subjected to trauma on multiple levels, that contributes to outcomes.”
Speaking on race and implicit bias in medicine, Gulati added that even if two people of different races live in a place such as Montgomery County, “the outcomes will still be different.” He suggested that more money be invested in researching the health issues of Black people, rather than applying mainstream health studies to minorities.
Raynard Washington, Ph.D., Chief Epidemiologist, Philadelphia Department of Public Health, testified that “Black men have the lowest life expectancy in Philadelphia,” and that a child in North Philadelphia has to walk past 16 tobacco retailers on their way to school while a child in Chestnut Hill walks past one in the same distance. He also spoke on the high rates of lead poisoning in youth. To combat this and the other issues, he suggested the legislature pass policies that impact the housing and business sectors.
Washington said there needed to be legislation for ensuring “landlords [have] tested the house for lead; funding and investing in healthcare programs that promote healthy living; [and] making investments in neighborhoods not tied to gentrification.”
David Saunders, Director of Office of Health Equity, Pennsylvania Department of Health, reported that “African-American children are more likely to die from asthma than white children.” He also stated that although they make up only 11 percent and seven percent of the population, respectively, African-Americans and Hispanics account for 49 percent and 14 percent of all new HIV cases, respectively.
“Individuals with minimal education are less likely to be informed about risk,” said Saunders. “Education is not only a strong predictor of health outcomes, but it is also known to directly and indirectly improve health.” Speaking on the disparity of asthma in African-American youth, Saunders said it is a policy and business concern because “it comes back to the environmental issues in a lot of African-American and Latino communities.”
The hearing closed with testimony on maternal health and how women and their unborn babies are affected by living in underserved communities.
Laura Handel, Managing Attorney with the Medical Legal Partnership, spoke of working with clients in Chester who have “slept in cars with babies, living in model infested apartments that landlords refuse to address” and suffer from a lack of affordable housing, affordable transportation and childcare.
Caral LeCoin, Nurse for the Maternal Infant Department, agreed.
“I know some moms give up,” she said. “They’re frustrated due to a lack of access, insurance issues. We need to tackle these healthcare disparities.”
State Rep. Morgan Cephas, D- 192, said the information gathered at the hearing will initiate conversation on policy changes and funding.
“Today’s conversation brought experts in the room from different lenses. You had health insurance providers, you had physicians, you had doctors, you had practitioners, you had advocacy groups. Getting us all in the room to identify the problem is key but then also figure out what solutions can be made when it comes from a funding perspective, a policy perspective and a legislative perspective,” said Cephas. “There were some significant recommendations that we are going to take back as a caucus to try to move the needle to ensure that we have healthy communities.”
“The governor has the power to shift some resources as necessary and if we can show there’s a great need to shift resources and or change direction of his administration as it relates to healthcare and healthcare issues, then that’s what we will have that conversation about,” he said. “Right now, we are gathering information and we will have a deliberate conversation within the democratic caucus and then take certain information to meet with the governor’s folks and try to roll out a course of action.”