Date: 2003-11-18
Speaker: EDDIE BERNICE JOHNSON (democrat)
Chamber: H
State: Texas

Mr. Speaker. I rise today to address the need for racial equity in health care in our great Nation. As a former nurse. I have spent much of my public career working to ensure that the nations health care system is affordable and provides the best services possible to all Americans. Disparities in the burden of death and illness experienced by AfricanAmericans. as compared with the U.S. population as a whole. have existed since the government began tracking such statistics. These disparities persist. and in some areas continue to grow. Cardiovascular disease is the leading cause of death for all racial and ethnic groups. with a disproportionate burden of death and disability from cardiovascular disease in minority and lowincome populations. The prevalence of diabetes in African Americans is approximately 70 percent higher than whites. Racial and ethnic minorities have higher rates of hypertension. tend to develop hypertension at an earlier age. and are less likely to undergo treatment to control their blood pressure. Many minority groups suffer disproportionately from cancer and disparities exist in both mortality and incidence rates. For men and women combined. AfricanAmericans have a cancer death rate about 35 percent higher than that for whites. AfricanAmerican women develop breast cancer less often than do white women. but have a higher mortality rate (27 per 100.000). due most likely to later diagnosis and late entry into treatment. AfricanAmerican and Hispanic women have higher cervical cancer death rates. The incidence rate for lung cancer in AfricanAmerican men is about 50 percent higher than in white men and the death rate is about 27 percent higher. The prostate cancer mortality rate for AfricanAmerican men is more than twice that of white men. AfricanAmerican women are less likely to receive care. and when they do receive it. are more likely to have received it late. For example. one out of four AfricanAmerican mothers did not receive prenatal care during the first trimester during 1999. Other risk factors. such as obesity. contributes to heart disease. diabetes. and stroke. Approximately 69 percent of AfricanAmerican woman between the ages of 20 and 74 were overweight during the period 1988 through 1994. The prevalence of obesity in minority populations can be as much as three times higher than that of whites. and is higher among women than men. African Americans and Hispanics have a particularly high prevalence rate of obesity as do Pacific Islanders. Native Americans. Alaska Natives. and Native Hawaiians. More than 75 percent of AIDS cases reported among women and children occur in minority women and children. While racial and ethnic groups account only for about 25 percent of the total United States population. they account for more than 50 percent of all AIDS cases. Children from minority communities are disproportionately represented among those with incomplete immunizations. In addilion. infant death rates among minority populations are above the national average. with the greatest disparity existing among African Americans. Minority populations are at the greatest risk for SIDS. The rates for the uninsured minority are quite frightening. Blacks and Latinos are far more likely to be uninsured when compared to their Anglo or white counterparts. Nationally. 11.6 percent of the Anglo population. 20.1 percent of the African American population and 34.8 percent of the Hispanic population are without health insurance. In Texas. while12 percent of whites are uninsured. 21.2 percent of African Americans and 36.7 percent of Hispanics do not have medical coverage. That is why I am an original cosponsor of The Healthcare Equality and Accountability Act of 2003. The Healthcare Equality and Accountability Act of 2003 would reduce health disparities and improve the quality of care for racial and ethnic minorities by: First. expanding health coverage. To reduce the number of minorities without health insurance. the bill would give states the option to expand eligibility and streamline enrollment in Medicaid and the State Childrens Health Insurance Program. This bill also removes language and cultural barriers to good health care that plague many of our minority communities. Because language and cultural differences create barriers to health care. the bill would help patients from diverse backgrounds. including those with limited English proficiency. with provisions such as codifying existing standards for culturally and linguistically appropriate health care. assisting health care professionals provide cultural and language services. and increasing federal reimbursement for these services. Instruments in this bill have been put in place to encourage workforce diversity. Increasing the number ofminority health care providers will improve access to care because these providers are more likely to serve lowincome. uninsured. and minority patients. Date collection would be improved to better identify sources of health disparities. implement effective solutions. and monitor Improvement. Under this bill. the Office of Civil Rights and the Office of Minority Health and the Department of Health at Human Services (DHHS) would be expanded to promoting accountability and reduce health disparities. And finally. this bill strengthens health institutions that serve minority populations. By establishing loan and grant programs. health institutions that provide substantial care to minority populations will receive necessary funding to carry our their mandates. Protecting the health care of citlzens. no matter their ethnicity or race. should be the number one priority of any great nation. An investment in our health care system is one of the wisest investments we can make for the future of this country. Now is the time for all Americans to have equal access to quality health care and meaningful patient protections. That is why I urge my colleagues to support this legislation. Our citizens deserve and expect nothing less.