![[logo] US EPA](http://www.epa.gov/epafiles/images/logo_epaseal.gif){kind=logo}
Statement Of Stephen B. Thomas
 |
Testimony of Stephen B. Thomas, PH.D. Philip Hallen Professor of Community Health & Social Justice and Director, Center For Minority Health Department of Behavioral and Community Health Sciences Graduate School of Public Health University of Pittsburgh.
It seems like any other Sunday morning for members of the Central Baptist Church in Pittsburgh's Hill District. They are patiently awaiting the start of the weekly service. When an elderly gentleman from the church's predominantly African-American neighborhood arrives a few minutes early that, too, isn't out of the ordinary.
Still, something isn't right. Before the man takes his seat in
the church pews, some friends approach him.
"You don't look so good," they tell Percy Thomas, a
78-year-old grandfather. "Are you sick?" Thomas insists
he is fine. "Look," they plead, "there are some
nurses downstairs today doing health screenings. Go down there.
Get checked."
"Okay, okay," Thomas agrees at last and walks slowly downstairs, where he meets with student nurses from the University of Pittsburgh. The nurses there that early April day were part of a program to eliminate disparities in healthcare based on race. The program is one of the keys to the Center for Minority Health's initiative: African-American Health Promotion, Campaign Countdown to 2010. Through this program, as the Center's director, I want to initiate healthcare services in churches, supermarkets, and other places where people gather, just like what happened with Percy Thomas (no relation to me). Instead of trying to figure out why people don't show up for clinic appointments, we go to the people. It's really about building trust. In addition to saving lives, eradicating health disparities in the population can have a huge payoff. Simple blood pressure screening in a church basement, for example, may identify individuals on the verge of having a stroke. Treating stroke patients costs about $15,000 during the first 90 days, according to the National Institute of Neurological Disorders and Stroke. The cost doesn't include permanent disability, which affects 15 to 30 percent of stroke patients. Many things can explain why some people are healthier than others. Cigarette smoking. Education level. Joblessness. Poverty. Now, race has emerged as a reliable indicator of one's health, even though there is no biological reason for the difference. Take a look at some numbers: Black mothers in America die from childbirth complications at a rate nearly four times higher than the rate for white mothers, according to the most recent data compiled by the US Department of Health and Human Services. Cervical cancer rates for black women are three times the rate for white women. Blacks have the highest overall risk for kidney disease, and black men have the highest death rates for cancers of the colon, rectum, lung, and prostate. In fact, minorities are affected more often, receive less aggressive treatment, and die sooner than whites from every major cause of death, according to Thomas. The latest proof of disparities in healthcare came in March in a troubling study by the Institute of Medicine, based in Washington, DC. The IOM found that minorities in the United States receive lower quality healthcare than whites, even when insurance coverage and income are the same. The report found that when compared to whites, minority patients were less likely to be given appropriate medications for heart disease, receive kidney dialysis or organ transplants, or undergo heart bypass surgery. Even among recipients of Medicaid, the government healthcare program for poor people, the institute found that blacks were almost four times more likely than whites to have their legs amputated because of diabetes. Back in the basement of Central Baptist Church that April morning, a University of Pittsburgh student nurse takes Percy Thomas' blood pressure. The reading is dangerously high. A friend offers to take him to the hospital. He is reluctant, but agrees finally. After treatment in the emergency room, Thomas is admitted to the hospital for three days. Changes in his diet and medications cut his sky-high blood pressure. Now he's back to his normal routine at home, having narrowly averted what may have been a catastrophic stroke. He divides his time between church work, and volunteering at a nursing home where he fills water pitchers and does other chores for patients. Since that morning in church, Percy Thomas has also become a believer in Pitt's approach to preventive healthcare. "It's a godsend," he says. It is critical that the EPA identify environmental factors associated with racial and ethnic health disparities and set a course to eliminate health inequality. Thank you very much.
Stephen B. Thomas