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Healthcare system a major factor in African Americans' poorer health

Part one of two

EYE ON HEALTH

Jonathan D. Walker, M.D.

When it comes to overall health, African Americans tend to do much worse than average. A few examples: according to the Center for Disease Control, death rates for black Americans surpass those of Americans overall for heart disease, cancer, diabetes and HIV. According to a study published in Health Services Research, white males live approximately seven years longer than African American males, and white women live more than five years longer than black women. Finally, African Americans fare far worse when it comes to infant mortality-their rate is almost double the national average.

There are a lot of different reasons for all this. Part of this is genetic- some diseases are simply worse for African Americans, such as prostate cancer and glaucoma (a disease of the eye). Another part of the problem is cultural; African Americans as a group tend to be more apprehensive of the healthcare system and are less likely to go to a doctor. Other factors include a person's level of education and income-these can play into lifestyle choices regarding smoking, diet and exercise.

But, there is also one huge problem that contributes to this negative outlook for African Americans: lack of insurance. And nowadays, most private insurance plans include such high outof- pocket expenses that it can be too costly to see a doctor, even if someone has insurance. This is known as "under-insurance," and it is becoming as much of a problem as having no insurance at all.

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