It can mean the difference between a patient receiving hormones to shrink pelvic tumors or undergoing a more drastic measure such as a hysterectomy. It can influence whether a blocked blood vessel in the leg leads to surgery to save the leg, or the leg is amputated. Generally, better health insurance begets better treatment than that given at charitable health-care facilities. But not always. For example, older black patients on Medicare received costly heart-bypass operations only about a fourth as often as older white patients on Medicare, according to a 1992 study published in the Journal of the American Medical Association.
Poverty is a key reason black health statistics are so bad.
Nationally, about 28 percent of blacks are poor. It is patients' poverty that makes it difficult for the health coalition to find doctors who will treat them, said Peterson-Hines, who has been searching for doctors who will provide ongoing care for poor and minority people in the county. The risk of dying young is three times higher for the poor than the wealthy, said Bruce Link, a social epidemiologist. The risk has remained constant even though the killers 100 years ago were infectious diseasesand the killers now are chronic illnesses. Link says it could simply be the sense of having control over one's life.