Health Disparities Need Not Be Care Disparities
Empowering African Americans by Education on Healthcare and Risk Factors

TRENTON, N.J., February 24, 2003 -

"Minority cardiac patients received less care than their white counterparts and that includes diagnostic screening, drug treatment and surgery," according to a Kaiser Family Foundation release that reviewed 81 separate studies, conducted between 1981 to 2001.

"We are in the 21st century and this disparity of care should not occur?. yet, it still does," opened Dr. Philip M. Bonaparte, Chief Medical Officer for Horizon/Mercy, as he cited these study results during his presentation at a St. Francis Medical Center event in honor of Black History Month on February 19, 2003. Speaking to an audience of doctors, nurses, hospital staff and community leaders, Dr. Bonaparte commented on the disparities in care and emphasized the need to inform and educate African Americans on disease management.

"That's why I am discussing healthcare during Black History Month," he said. "Our two organizations, St. Francis Medical Center, an inner city hospital providing care to the community and Horizon/Mercy, New Jersey's largest managed health care organization serving the publicly insured, have a common mission and vision in that we share our concern for the needs of the underserved."

"Chronic diseases, such as heart disease and diabetes, have an excessive impact on minority populations," added Dr. Bonaparte. To illustrate his point, he cited studies that showed:

• The prevalence of diabetes among African Americans is about 70% higher than among white Americans.
• The number one killer of American women is heart disease and 66 % of women who die suddenly had no prior symptoms. African American women have a higher incidence of certain risk factors, such as smoking, high blood pressure, physical inactivity and obesity.
• African Americans are more likely to die from stroke and at a much younger age than other ethnic populations.
• According to data conducted in a national survey by the Centers for Disease Control (CDC) in 1997, "Compared to Asians and Pacific Islanders and whites, members of other racial groups have less access to health care, poorer health status, more health-risk behaviors and use certain preventive services less often."

"Considering the staggering losses caused by chronic diseases among African Americans," he said, "studies show that education is important. When a physician tells people to stop smoking?they stop smoking. I believe that you can empower and educate yourselves on basic medical conditions that are predominant in the African American community. For all patients: advocate on your own behalf and always ask your doctor questions."

"African Americans have a high incidence for the risk factors involved in many diseases, especially heart disease and diabetes and some risk factors you can control," remarked Dr. Bonaparte.

He listed risk factors for heart disease, which include: smoking, physical inactivity, obesity and high blood pressure or hypertension. "Education on the basic medical conditions and learning these factors can help to prevent such pervasive illnesses."

• Diabetes affects 16.7 million people and over 2.3 million African Americans have been diagnosed with this disease, but another 730,000 are walking around with undiagnosed diabetes. At least 16 million more Americans have pre-diabetes.

"African Americans and all ethnic groups can become aware of and learn the risk factors," Dr. Bonaparte stated. "There is also a strong correlation between Diabetes Mellitus and Hypertension. By educating patients about the risks, we can help manage these diseases."

He offered possible solutions: "While African Americans experience higher rates of disease, many of the risk factors can be modified. Changes in lifestyle and behavior can reduce the severity of these factors and act as a preventive measure against these diseases and the conditions that create the disease."

Management and education can both help increase health while decreasing risk factors for these diseases. Making simple lifestyle changes, such as taking the stairs instead of an elevator, can make a difference, if one follows some simple steps:

• Lose 5 to 7 percent of your body weight
• Diet and Exercise - a study showed that there was a 58% reduction in risk compared to 37% reduction with Glucoph - medication.
• Tight control on blood pressure
• Role of ACE Inhibitor in Diabetes Mellitus patients important

The dangers and the complications are considerable, because without management of the factors for these diseases, one risks:

• Stroke
• Heart Attack
• Heart failure
• Blindness
• Amputations
• Neuropathy
• Impotence

Horizon/Mercy is New Jersey's largest managed health care organization serving the publicly insured, providing health services to more than 270,000 people in all 21 New Jersey counties. The company was nationally recognized by the American Association of Health Plans for its outreach and unique member programs in a 2002 national report, "Innovations in Medicaid Managed Care." Headquartered in West Trenton, NJ, Horizon/Mercy is a wholly owned subsidiary of Horizon Blue Cross Blue Shield of New Jersey.

According to a new federal report through the Center for Disease Control (CDC), in a February 20, 2003 release (REUTERS):

• Blacks in the United States are more likely to die from a stroke at a much younger age than whites, Hispanics and people of other races.
• The pattern confirmed concerns over racial disparities in diet, smoking and access to health care that led to wide differences in the rates of heart disease, stroke and cancer.
• 165,000 Americans die yearly from a stroke and the major risk factors are high blood pressure, high cholesterol, diabetes and smoking.
• Each year, from 1991 to 1998, 166 out 100,000 black Americans had fatal strokes, which is 1.4 times the rate for whites (117 per 100,000).
• Among blacks, almost half of deaths from stroke occurred before age 75, compared with only 25% for whites.

HEART DISEASE RISK FACTORS AMONG AFRICAN AMERICANS
(Many of the risk factors are avoidable or controllable)

• Smoking
• High Blood Pressure or Hypertension Physical Inactivity
• Obesity

HYPERTENSION

• High Blood Pressure
• Normal Blood Pressure,14/90
• Known as the Silent Killer with few symptoms
• The leading cause for heart and renal failure

DIABETES RISK FACTORS

• Age > 45
• Ethnic Groups, African Americans, Hispanics, Native Americans
• Family history of Diabetes Mellitus (DM)
• Overweight
• Gestational DM
• Sedentary lifestyle

SYMPTOMS of DIABETES

• Frequent urination with Nocturia
• Increased thirst
• Unexpected weight loss
• Increased appetite
• Frequent yeast infections
• Visual changes

MANAGEMENT

• Strong correlation Between DM and Hypertension
• Changes in lifestyle
• Diet and exercise
• Lose 5 to 7 percent of your body weight
• Control of Blood Pressure
• ACE Inhibitor in patients with DM

Horizon/Mercy is New Jersey's largest managed health care organization serving the publicly insured, providing health services to more than 280,000 people in all 21 New Jersey counties. The company was nationally recognized by the American Association of Health Plans for its outreach and unique member programs in a report, "Innovations in Medicaid Managed Care." Headquartered in West Trenton, NJ, Horizon/Mercy is a wholly owned subsidiary of Horizon Blue Cross Blue Shield of New Jersey.