| One of the most significant issues to be addressed
by health community is disparities in health and health care for
minorities, particularly African Americans. African Americans still
suffer from the generational effect of a slave health deficit.
African Americans lag behind on nearly every health indicator,
including life expectancy, death rates, infant mortality, low birth
weight rates and disease rates. African Americans are sicker than
European Americans. Blacks have shorter lives - Blacks are quite
literally dying from being black! This black health deficit is
directly traceable to the slave health deficit. The slave health
deficit that was established during slavery was not relieved during
the reconstruction period (1865-1870), Jim Crow Era (1870-1965) ,
the Affirmative Action Era (1965-1980) or the Racial entrenchment
era (1980 to present). Also, established at the time was a health
care deficit. That continues to exist.
Repairing the health of African Americans will require a
multi-facet long term legal and financial commitment. Reparations
is not merely a monetary cash payment, Reparation is also an
equitable remedy that requires that the harm be repaired not that
money be paid. The United States government because of its
legal sanction of slavery, an international crime against humanity,
is obligate to do whatever it takes to repair black health. I
propose a specific program of equitable, rather than compensatory,
reparations including a comprehensive health care civil rights law. This book will include approximately 200+
pages organized in the following chapters:
Chapter 1, "Introduction",
provides and overview to the problem to be addressed in
this book. That African Americans are sicker and
die at a higher rate than European Americans is a
well-documented fact. That current health disparities
are directly traceable to slavery is a fact that is not
well understood. African Americans still suffer from the
generational effects of a slave health deficit. And
reparations could repair that deficit. In health and in
health care, race matters. The need to focus on
African-American health care and health care reform is
overwhelming. Not only are African-Americans sicker than
European-Americans, they are dying at a significantly
higher rate or "Dying While Black."
Chapter 2, "From Slave Health Deficit to Black Health
Disparities", traces the health status deficit of
African Americans from slavery through Jim Crow to the
twenty-first century. It argues that the deplorable
state of Black people’s health is directly traceable to
slavery. It discusses the current health status of
African Americans. African Americans have
disproportionately negative indicators on nearly every
health indicator, including life expectancy, death
rates, infant mortality, low birth weight rates and
disease rates. African Americans are sicker than
European Americans. Blacks have shorter lives. In
short, they are literally dying from being Black!
Chapter 3, "Racist Health Care," addresses the
racial disparity in the health care system This
disparities exist in access to health care and the
quality of treatment received. Racial disparity is
manifested in racial barriers to hospitals, to nursing
homes, and to physicians and other providers. Finally,
shortage of minority health professionals affects both
access to health care and minority input into the health
care system. The presence of a "racist health care"
system is perpetuating the slave health deficit.
However, racial barriers to access are only one aspect
of a racialized health care system. The other aspect is
racial disparities in the type of services ordered and
in the provision of medical treatment. Discrimination in
treatment is a substantial factor in disparity in the
health status of African Americans. It is imperative
that the health care system be free of both outright and
inadvertent racial discrimination.
Chapter 4, "Targeting the Black Community",
Chapter 5, “Impact of Managed
Care on Blacks" addresses the rationing goal of
managed health care organization and its impact on
African Americans. Managed care organizations (MCOs)
complicate the problem of racially disparate health care
because they increase the incentives for providers and
facilities to engage in discrimination.
Chapter 6, "Slavery, Segregation and Racism: Trusting
the Health Care System: It Ain't Always Easy to Trust
the Health Care System, discusses the significant
distrust towards the health care system in the African
American community. This distrust is not just paranoia
but is built on a history of abuses that includes
experimentation, the Sickle Cell Screening Initiative,
family planning/involuntary sterilization, and the
complicity of the medical system in justifying racism
and discrimination. Rebuilding the trust between African
Americans and the health care system will be essential
if the "Black Health Deficit" is to be eliminated.
Chapter 7, "Health Care in the U.S. as a Violation of
International Human Rights" discusses how the
combination of racial disparity in health status,
institutional racism in health care and inadequate legal
protection points to serious human rights violations
under the International Convention on the Elimination of
All Forms of Racial Discrimination "(CERD or
Convention).
Chapter 8, "Reparations: Repairing Black Health",
discusses the legitimacy of the demand for reparations,
but restructures the call from a compensation request to
an equity request. The Slave Health deficit will be
removed only if the United States makes the same a
significant and sustained commitment that it made to
landing on the moon. in order to eliminate the slave
health deficit, the government will need to: (1)
eliminate disparities in morbidity and mortality, (2)
assure access to health care (3) assure quality health
care (4) eliminate racial disparities in health care and
health research (5) enhance data collection and (6)
enact a comprehensive health care civil rights law. The
burden of a slave health deficit has been a continuous
burden and will only be relieved lifted with a well
coordinated aggressive and comprehensive reparations and
legal
program. |
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