Advocacy and preventive screenings improve health care |

Nothing in life is perfect, not even healthcare. If healthcare was perfect then health disparities would not exist and health outcomes would not be determined by one’s race, gender, ethnicity, or financial resources. The health system in this country is flawed which leads to unfavorable results for certain minority populations particularly, African Americans.

Disease prevention care is a crucial component of wellness for everyone but is not readily available for all populations. Many evidenced-based screenings, such as pap smears, colon cancer screens, and mammograms exist, but some populations lack access to them.  Furthermore, not all cancers or diseases have associated screenings. Compared to the general US population, African Americans have higher rates of certain chronic conditions such as diabetes, stroke, hypertension, and obesity. 

Though cancer can affect anyone, in the United States, African Americans have the highest rates of cancer compared to other ethnic groups. Compared to white women, black women are 40% more likely to die of breast cancer. Prostate cancer deaths in black men is more than twice that of white men.

One of the major barriers to preventive screenings is access. Colonoscopies, for instance, require the patient to have a driver to pick them up post procedure. In addition, the patient most likely needs an additional day off from work to perform the prep the day before. If you work in a non-professional setting, you most likely do not have adequate sick days. Therefore, getting the procedure done would mean no pay. Such a scenario would then help explain why colonoscopy rates are only 38% in the African American population.

African Americans make up roughly 14% of the population but 35% percent of the population with end stage kidney disease. Diabetes and hypertension are risk factors for chronic kidney disease. For many years, however, the calculation tool used to determine kidney function included race. The formula used included a Black race variable which increased eGFR values and overestimated kidney function by up to 16% which potentially delayed appropriate diagnosis and care such as dialysis and being placed on the transplant list. This variable has now been eliminated and the GFR calculation uses race-neutral criteria.

To combat these disparities, I encourage patients to begin to advocate for themselves and family members. Speak with your provider and ask if you are up to date on your preventive screenings. Have you had your blood pressure checked? Have you been screened for diabetes and high cholesterol?  Have you had a mammogram? Have you been screened for prostate cancer? Have you had a bone density test?

Immunizations also prevent diseases. Vaccines are not just for children. In many cases, you may also need a booster or two. Ask your provider about the Tdap and shingles vaccines.

Lastly, don’t forget how important it is to have some knowledge of your family history. For instance, breast cancer in a first degree relative increases your risk of breast cancer. Knowing that information may change when the first mammogram is recommended and the cadence of future imaging. This is also true of colon cancer screenings.

Some individuals in our country would prefer to eliminate discussions regarding the impact of racism and discrimination on healthcare. However, such ignorance leads to continued disparities and increased morbidity and mortality. As a community we must continue to push for discoveries that provide insight into the inequitable care we receive and demand changes in how care is provided.