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Minority Health Disparities: Redemption Through Data?

February 10, 2005—"Of all the forms of inequality, injustice in health care is the most inhumane," Democratic delegate to Congress Donna M. Christensen said when addressing a press briefing Tuesday on minority health care disparities, quoting Martin Luther King, Jr. There is no reason why African American men should live nine years less than white men, that African American women should live six years less than white women, or that African -American babies should die twice as often during infancy, she said.

To help end those disparities in health status, Christensen, an up-and-comer in the Democratic caucus who represents the Virgin Islands, is linking together with former House Speaker Newt Gingrich, former House Republican James Greenwood, and former House Democrat Peter Deutsch, to make the case that detailed data on the nature of disparities and the zip codes in congressional districts in which they are concentrated will help erase the gap.

The new Congressional Leadership Alliance, a partnership between elected officials, drug companies, minority doctors, and consumers, plans to announce "health disparity zones" a few months from now in eight congressional districts.

Project designers envision the eight districts as a pilot for what can be done elsewhere in the country. Deutsch said he's convinced the disparity numbers can be changed in those areas, and once that happens, he hopes Congress will force action on a wider scale.

Targeting the problem by zip codes "really allows you to identify health needs in a practical, actionable way," said Gingrich. The eventual goal is to have each congressional district in the country meet national averages on health status and to move those national averages up, said Gingrich.

The National Minority Health Month Foundation defines a disparity zone as "a disproportionate incidence of [chronic] diseases and conditions occurs in the elderly, and in racial and ethnic minority groups."

"These patients often reside in health disparity zones—contiguous ZIP codes characterized by a disproportionate prevalence of diseases and conditions that can be linked to higher death rates, greater hospitalization rates, and cost."

As an example, the group used a color map to illustrate disparities in the 5th Congressional district in Atlanta, represented by Rep. John Lewis, D-Ga.

"The rate of premature morbidity due to cardiovascular disease is almost 400 percent higher in the red area—a cluster of 19 zip codes—versus the green area on the map," the foundation said. "These populations experience not only a disproportionate share of the morbidity and mortality associated with these conditions, but also a resulting disproportionate share of the social and economic costs."

The alliance was vague about how it would tackle disparities once they are identified, saying it would draw on the resources of its various members and rely on "evidence-based" treatment practices.

Asked where actual dollars would come from, Gingrich pointed to Medicaid and public health dollars already in the system. Health officials would eagerly target these funds if they knew precisely where they could get the biggest impact for their money in closing wide disparities, he suggested. The foundation said it already has data on disparities for each of the congressional districts in the country. Among the sources of the data are the Centers for Disease Control and Prevention and various state and local agencies, a spokeswoman said.

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