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News Bits from MichUHCAN January 1999 Newsletter

Voices of Detroit

"Over one-fourth of Detroit residents - and not by choice - are without health insurance or have inadequate insurance," said Gail Warden, President and CEO of Henry Ford Health System. Recently Ford and other Detroit hospitals, working with the city's Health Department, received a $5 million grant for the "Voices of Detroit" initiative to improve access for Detroit's under-served. But the hospitals also say the initiative will allow them to reduce the cost of uncompensated care.

Can they do both? for instance, one of the first goals is "to move the uninsured out of the emergency room and into the physician's office" for care; if achieved, that would save money by moderating the use of expensive ER services. But there's also danger of hospitals and doctors trying to dump patients on each other.

No Specialists Available

Sr. Mary Ellen Howard, who manages Most Holy Trinity medical clinic in Corktown, told the New York Times that the clinic staff and volunteers "cannot get any kind of a specialist to see a poor person in the city of Detroit." Some of the clinic's patients need more evaluation than the clinic can do, but do not have emergency problems, suitable for emergency room treatment. S. Mary Ellen says physicians she used to be able to refer patients to now say "sorry" because of other committments.

Black - White Health Gap

The federal department of Health and Human Services has launched a study of the persistent health gap between white and black Americans. The gap persists even among highly-educated African-Americans and those in the middle class with health insurance (statistically, health improves with education level and income).

The differences between whites and blacks occur across nearly every major disease. African-Americans are nearly twice as likely to die of stroke, 40 percent more likely to die of heart disease, and 35 percent more likely to die of cancer. Life expectancy is six and one-half years shorter than whites'.

Experts suggest several possible reasons for the disparity between whites and blacks of similar education and income. For one, a higher proportion of the African-Americans are likely to have grown up poor, perhaps affecting later health. Also, blacks of almost any income level are likely to face more stress in a white-dominated society. The fact that most physicians are white hurts doctor-patient communication. And of course outright racism sometimes prevents blacks getting the best care.