Cultural Disparity In Health Care?:
Task Force Takes A Hard Look
At White Health Care Vs. Black

According to Michael Carter, director of the Office of Civic Rights of the U.S. Department of Health and Human Services, there is a marked distinction in the medical response to people from minority groups and people from the Caucasian community.

"There are often differences in diagnosis, prognosis and recovery when two people — black and white present with the same symptoms," said Carter.

"If you’re a black male born today with a white male, you can expect to live eight years less than your white counterpart. Articles show that there’s a lack of sensitivity and certain protocols are present when patients of color present," he said.

According to Carter, the disparity starts in infancy and continues throughout the life of the individual.

"In Southeast Queens, the infant mortality rate is twice that of the rest of the borough," he said. "There is a certain lack of understanding and lack of commitment."

A spokesperson for Jamaica Hospital said they’re fighting healthcare disparity by making primary care more accessible. PRESS Photo by Ira Cohen

But if Carter is disappointed in healthcare providers, he is also chagrined with what he considered the lack of action on the part of the community.

"There is a higher incidence of death from breast cancer among black women and yet we don’t have a health agenda," he said.

Carter also said there is a higher incidence of asthma among African American children than there is among their counterparts in other communities quoting a 1998 study, that reported a 13.6 percent mortality rate per 1,000 children born in Laurelton.

The numbers, in fact, are so alarming to Scarborough that he has introduced a bill in the New York State Assembly to combat the problem.

The numbers and the situation has become so alarming that one local legislator is pushing for the passage of a state bill to combat the problem.

Assemblyman William Scarborough has introduced a bill in the New York State Assembly known as A3181 or "The Cultural Competency Health Bill."

According to the Assemblyman, the bill is "an act to amend the education law, in relation to authorizing the state board for medicine and the commissioner of education to promulgate rules and regulations for physician training.

"Research has shown that most of us have anecdotal experience with cultural disparity in healthcare," said Scarborough. "Now we’re having documented proof. We are looking to require that as part of the training in medical school that the doctors be trained in the characteristics of medical conditions in minority groups. There are a lot of stereotypes."

With this new bill, Scarborough also seeks to enforce a 1991 stipulation in the education law, which says the New York State Board of Medicine must include "one or more cultural competency courses." It is designed to address the problem of race and gender-based disparities in medical treatment decisions and developed "in consultation with the Association of American Medical Colleges or another nationally recognized organization, which reviews medical school curricula."

For Linda Hazel, an educator from St. Alban’s, A3181 is a much-needed bill.

Hazel recalled her nightmarish experience of trying to get treatment when she went to a Queens hospital.

"The doctors were talking over me as if I wasn’t even there," she said. "And they were more interested in my sexual orientation and how many partners I had had. It was only after they found out I had a master’s degree and I could program a computer that their attitude changed. But it doesn’t matter who you are, she said."

Hazel also related that she had to call Councilman Archie Spigner’s office just to get an aspirin at the hospital because that was the only treatment that would cool her 105 degree temperature.

She also maintains that it was not the physicians who saved her life in that hospital but rather, "the little ladies who give out the water at nights." Her suggestion is for patients to empower themselves prior to going into the hospital.

"Once you get a diagnosis of cancer, send away to the National Institute of Health and to the Cancer Alliance for the latest research so that you can fight," she advised.

Wesley Parrott, also a cancer survivor, concurs that the onus is on the patient to ensure they get the best care possible.

"You are the person who has to demand of your doctor what you want," he said. "You have to demand it!"

According to Ole Pedersen, vice president of public affairs at Jamaica Hospital, they are making all efforts to ensure the highest care for all patients regardless of ethnicity.

"We are very attuned to the community we serve," said Pedersen. "Both patients and physicians are from this community. Some we’ve set up in offices in the community. We put in first class facilities in brand new state of the art buildings with state of the art equipments."

Pedersen asserted that the majority of Jamaica’s physicians are from the community. He also explained that drastic measures taken by physicians in treating patients is often a last resort based on how early the patient sought medical assistance.

"Sometimes the problem is access to care," he explained.

"If you haven’t been getting ongoing care, the problem becomes more acute and therefore the outcome is less favorable. Unfortunately there are lots of uninsured patients so they are hesitant, they wait until very late along to seek help. That is why we are putting in all these primary care facilities. It is to give people access to physicians they’ll see on a regular basis, you can manage your health."

Pedersen said that his hospital is lobbying local, state and federal elected officials trying to "persuade them to deal with issues of uninsured illegal immigrants."

At St. Vincent Catholic Medical Centers, which includes Mary Immaculate Hospital, Juliet Lewis, director of communications for Brooklyn and Queens, agrees with Scarborough’s position that it is essential that residents be at the very least, orientated to the community in which they serve.

"As a Catholic organization we cannot show any bias," she said. "Our mission is to provide quality care. We would take disciplinary action if that happened. But our residents do go through orientation, you have to understand the neighborhood your serving."

Like so many other hospitals, Mary Immaculate and the sister hospitals, participate in health fairs performing free screenings for the community; however, according to Lewis, some patients after receiving a diagnosis don’t do the requisite follow-up for treatment at the hospital.

Instead, she said, they become "health fair junkies" going from health fair to health fair hoping for a negative diagnosis.

According to Scarborough, even after all the variables are considered, there is still a cultural misunderstanding on the part of healthcare professionals whose ethnic backgrounds differ from that of their patients and that is the wrong he is seeking to correct with Assembly Bill 3181.

To support the assembly bill, write to Assemblyman William Scarborough’s office at 114-52A Merrick Blvd., St. Albans 11434 or call 657-5312.