Slides on Race, Poverty and Health Care

Martin Donohoe, MD, FACP

U.S. Population 1990U.S. Population 1990(250 million)(250 million)

Race (%) Change from 1980 (%)

- White 83 6

- African-American 12 13

- Native American 1 38

- Asian & Pacific Islander

3 108

Hispanic Origin(from Central or So.America, Spain, orCarribean)

9 53

U.S. Population (1990)U.S. Population (1990)

Hispanic Origin 22.4 Million

Asian 6.9 Million

Chinese 1.6 Million

Annual U.S. ImmigrationAnnual U.S. Immigration

• 800, 000 Legal800, 000 Legal

• 300, 000 300, 000 Illegal/UndocumentedIllegal/Undocumented

Racial Disparities: Economic

• Income disparities• Educational disparities• Higher levels of unemployment• Criminal justice system involvement• Toxic waste sitings / environmental injustice• Persistent overt / subtle discrimination

– E.g., “driving while black”

Racial Disparities: Health Care

• Higher maternal and infant mortality

• Higher death rates for most diseases

• Shorter life expectancies

• Less health insurance

• Fewer diagnostic tests / therapeutic procedures

Poverty RatePoverty Rate

• 11.2 % White11.2 % White

• 14.5 % Asian (bimodal 14.5 % Asian (bimodal distributions)distributions)

• 29.4% Latinos29.4% Latinos

Uninsured (Nationally)Uninsured (Nationally)

• 14% - Whites14% - Whites

• 20% - African Americans20% - African Americans

• 21% - Asian/Pacific Islanders21% - Asian/Pacific Islanders

• 34% - Latino34% - Latino

Uninsured (Oregon)Uninsured (Oregon)

• Hispanic 25%Hispanic 25%

• Non-Hispanic 9%Non-Hispanic 9%

Misconceptions About Misconceptions About CancerCancer

Cause Anglos Latinos

Sugar Substitutes 42% 58%

Bruises from trauma 34% 53%

Microwaves Ovens 23% 47%

Eating Pork 11% 31%

Eating Spicy Food 8% 15%

Breast Feeding 6% 14%

Antibiotics 12% 32%

Misconceptions About Misconceptions About CancerCancer

Anglos Latinos (“fatalismo”)

Death Sentence 26% 46%

God’s Punishment 2% 7%

Largely Unpreventable 18% 26%

Uncomfortable to touch CA pt. 8% 13%

Would rather not know if hadincurable Cancer

23% 35%

Perez-Stable.JAMA 1992;268:3219-3223.