Summary of Speech on Health Care Disparities - July 31, 2010

HEALTH CARE DISPARITIES IN THE BLACK AMERICAN POPULATION

INTRODUCTION

When you hear the words "health care" the first thought that comes to mind is the association with medical dental and eye care, but "health care" encompasses more--it involves the home environment, the workplace and financial planning.

Earning the "minimum wage" does not provide significant income to address the basic necessities of living [as needed: rent, PG&E, telephone, Internet access, cell phone, cable TV, groceries] and for seniors--transitioning from independent living at-home to assisted living, or a nursing home.

Some African Americans in their communities may identify with a comment to the Metro Reporter by Pharoah Martin and Helen Trice Edney: "the desparate rate of unemployment and poverty in the Black community as well as what often amounts to poor quality health care." I will attempt to show there are resources to address these issues and their reasons.

Negligence is a greater problem in hospitals serving minorities

Record study shows errors in medication histories

The four biggest sources of retirement income

1. Employment
2. Social Security
3. Asset income
4. Pensions

Social Security

People of color are more likely to face poverty in their retirement years.

Beneficiaries:

80% of African Americans rely on Social Security for more than half of their total income.

Unemployment data, minorities and targeted strategies

Backs are earning on average 62 cents for every dollar earned by white workers (Jeannette Huezo).

When the bills are paid, Blacks only have 10 cents for every dollar of white wealth (Jeannette Huezo).

Facts about Alzheimer's and dementia

1. Sixth leading cause of death.
2. Compared to the general public, African Americans have a higher risk of diabetes and heart disease which can lead to vascular dementia.
3. More than 40% of African Americans have high blood pressure and are at risk for stroke which can lead to greater risk for developing dementia.

Income Level

1. Poverty (Very Low Income) is defined as 0-50% AMI [Average Median Income]. For one person in San Francisco that is $39,600.
2. Low Income is defined as 50-80% AMI. For one person in San Frasncisco that is $63,500.
3. The Area Median Income for San Francisco is $89,300.

Miniimum Wage Rate

2010 Minimum Wage Rate: $9.79/hour, effective January 1, 2010.

San Francisco Demographics

Racial makeup: 7.79% African American

Summary of Medicare Savings Program Eligibility & Benefits

1. People who are eligible for Medicare but worked fewer than 40 quarters have to pay a premium for Medicare Part A if they want Part A benefits.
2. Those who worked fewer than 30 quarters may also buy Part A and pay a monthly premium of $461.

Caregivers

Healthy San Francisco

Cobra Insurance

Single Short Term Medical: Monthly Payment: $340.56

Womens' Health

Medication (cost)

Auto Insurance

ZIP Codes in underserved communities: 94124

1. 2005 ninsured vehicle rate: 40%
2. Minority percentage: 90%
3. Per Capita income: $10,835

Hit-and-run accidents

African Americans suffer fatality rates well in excess of the population at large.

San Francisco Bicycle Coalition (statistics)

How the home environment affects the health

1. Aggravated asthma
2. Allergic reactions
3. Falls

How the workplace affects the health

1. Stress related illnesses
2. Weight gain
3. Affects sleep (insomnia)

Assisted Living Facility

Cost

1. Ranges between $250-$5,000/month
2. Medicare: 0
3. Medi-Cal: Limited to Assisted Living Waiver

Programs

Fresno, Los Angeles, Sacramento, San Joaqin, Sonoma; March 2010 expanded to San Bernadino and Riverside

African American Health

Newborn deaths

1998: 13.9 of every 100,000

Sudden infant deaths

1998: 140 out of every 100,000

Adults

10 leading causes of death:

African American

1. Heart disease
2. Cancer
3. Cerebrovascular disease (stroke)
4. Accidents
5. Diabetes
6. Homicides
7. Pneumonia and influenza
8. Respiraory disease (COPD)
9. HIV (AIDS)
10. Conditions originating in the prenatal period (period shortly before/after birth)

White

1. Heart disease
2. Cancer
3. Cerebrovascular disease (stroke)
4. Respiratory disease (COPD)
5. Accidents
6. Pneumonia and influenza
7. Diabetes
8. Suicide
9. Liver disease
10. Nephritis, nephrotic syndrome, nephrosis

CONCLUSION

Reason for disparities among African American seniors:

Lack of cooperation by professionals in providing data for related studies

e.g.: Questionnaires were sent to five pastors.

One responded that "he typically does not get involved in anything that separates the congregation racially, so I'm not sure if he'll participate or not."

To date, no response received from the five pastors.

Low or no attendance by African Americans at educational events

1. Protect Your Retirement Security: 10
2. AAA Senior Driver Expo: 5
3. OMI Neighborhood Tsunami: 3
4. Aloha Summer Senior Resource Fair: 3
5. Advance Direction: 0

Lack of education to prepare for aging

e.g.: How work history affects Medicare Savings Program

i.e.: Qualified Medicare Beneficiary Program

1. Most people do not pay a premium for Medicare Part A because they or their spouse earned enough credits by working 40 or more quarters (about 10 years of full-time work).


2. Worked fewer than 40 quarters have to pay a premium

30-39 quarters: $234 monthly

Less than 30 quarters: $461 monthly

Source: CALIFORNIA HEALTH ADVOCATES. "Low Income Assistance: Medicare Savings Programs.

Deficient in financial planning

Care providers do not keep statistics

e.g.: Sunday Streets (Bayview) - May 23, 2010

SFFD: "Statistics aren't kept on any of the participants. Don't collect, record or otherwise note ethnicity in Patient Care Reports."

BIBLIOGRAPHY

FOR THE RECORD. September 30, 1991. p. 17.

Braden, Emily. The 4 Biggest Sources of Retirement Income. www.usnews.com/money/blogs/planning-to-retire/2010/01/12/the-4-biggest-sources-of-retirement-income.Posted: January 12, 2010.

California Alliance for Retired Americans. "Share the Good News About Social Secuirty & Medicare."

SUNDAY MORNING NEWS. March 14, 2010. pp 2&6.

Alzheimer's Associan. Bay Area, Santa Cruz & Monterey Edition. Winter 2009 Newsletter - www.alz.org/norcal.

THE SAN FRANCISCO FOUNDATION. The Community Foundation of the Bay Area. www.sff.org/grantseeker/2006IncomeLevels20Defined.pdf.

Minimum Wage Ordinance (MWO). http://sfgsa.org/index.aspy?page=411.

San Francisco Demographics. www.thegreatwater.com/#Demographics.

California Health Advocates. caheaslthadvocates.org. FACT SHEET Low Income Assistance: Medicare Savings Program (E-001).

CALIFORNIA DEPARTMENT OF INSURANCE ESTIMATED RATE OF UNINSURED MOTORISTS. 2006 Commission Report on Underserved Communities. www.insurance.ca.gov/0400-news/0200-studies/reports/0800-underserved-comm/2006/upload/05UnderservedZips.pdf.

Saltau, Alison. SAN FRANCISCO EXAMINER. "General Facts About Hit and Run Accidents." January 17, 2005.

THE EXAMINER HEALTH SPOT. "Making your home a healthy one." [www.cdc.gov/healthyhomes]. May 20, 2010. p. 37.

Toland, Bill. THE EXAMINER HEALTH SPOT. "Workplace stress can take a toll on your waistline." May 20, 2010. p. 38.

RCFE/Assisted Living. www.canhr.org/RCFE/rcfe_costs.htm.

Net Wellness Consumer Health Information. African American Health. www.netwellness.org/healthtopics/aahealth/introduction.cfm.

(c) 2010. A. Matteson