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mortality has been dropping in Sub-Saharan Africa, rates actu- ally increased in the United States. Socioeconomic status, edu- cation, and other factors do not appear to protect black women from this risk, while factors including smoking, drug abuse, and obesity do not explain the differences. The article further reports that a black woman is 22% more likely to die of heart disease than a white woman, 71% more likely to perish from cervical cancer, and 243% more likely to die from pregnancy or childbirth related causes.
These same statistics for African Americans can be found as- sociated with cardiac and lung disease, infant mortality, breast cancer, colorectal cancer and more.
Although this is an issue for the medical community, it is im- portant to fully understand that this is a MULTIFACTORIAL problem, to which historic federal, state and local policies may be adverse contributors! In looking at causes involved with the aforementioned studies– those seeking answers would be remiss to think that the responsibility solely falls into the laps of the health professional community. There are many dynam- ics involved here. As an example, Social Determinants of Health (SDOH) play a critical role and as an important contributor, should not be overlooked. Recall that SDOH involves: Health equity concerns, income level, educational opportunities, occu- pation/ employment status, workplace safety, gender inequity, sexuality, disability, access to housing and utility services, access to safe drinking water, clean air, racial segregation, language bar- riers, cultural bias, lack of insurance, inability to pay for cost of
health care, lack of reliable public transportation, food insecuri- ty with inaccessibility of nutritious food choices, lack of social/ community support, neighborhood conditions, physical envi- ronmental challenges and more.
In closing, the next steps are long overdue. Health care dis- parities demonstrate significant and glaring gaps in health care, access and care outcomes for African Americans and other vul- nerable populations. These stem from a multitude of multifacto- rial challenges, involving health care access and delivery, social, historical, and economic causes.
Change is imperative and overdue, and it will require all par- ties to be willing and committed. As physicians and leaders, we have faced many major health care challenges in the past. This is another one! That said, change is possible, and the time for change has come. •
   Third Quarter 2020
Detroit Medical News 7
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3. article/2018/sep/focus-reducing-racial-disparities-health-care-confront ing?gclid=EAIaIQobChMIopfHrJTa6gIV0sDACh34Qw7eEAAYASAAE gJ_NPD_BwE

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