With Congress stalled on health care, blacks still looking within their communities to bridge health disparities
August 7th, 2017
By Deborah Barfield Barry | USA Today
BIRMINGHAM, Ala. — In a small room down the hall in the Greater Shiloh Missionary Baptist Church, about two dozen people listened one recent afternoon as Donald Solomon rattled off ailments ravaging African-American communities.
“We’re a sick crowd … Whatever is wrong in the country, we have it worse. We need to get health into the church,” said Solomon, a founder of Congregations for Public Health and co-author of Body and Soul, a healthy living guide for church leaders.
For four days in late July, pastors, deacons and folks running church kitchens and health ministries gathered in the Birmingham church to discuss a range of issues, including health concerns disproportionately affecting African Americans in their congregations and communities.
The conference sponsored by the Alabama Baptist State Congress of Christian Education drew hundreds from across the state.
It was one of several efforts nationwide aimed at helping close the health gap between blacks and whites. In other places, barbers are checking customer’s blood pressures, local corner stores are stocking shelves with fresh produce, and some preachers are even banning fried chicken from Sunday church dinners.
African Americans, particularly men, continue to lag behind their white counterparts on a host of health issues, including diabetes, heart disease and HIV.
Nowhere is this disparity more true than in the Deep South, where many blacks live and where there’s a long history of discrimination, poor health and insufficient insurance coverage.
While the disparity isn’t new, experts say it could get worse.
As Congress debates how to overhaul the Affordable Care Act, experts, community activists and pastors say African-American men are more likely than any other group to be left behind.
Republican alternatives to the ACA considered in the House and Senate have included massive cuts to Medicaid, which experts say would hit black men especially hard.
“At a time when we should really be working toward trying to close the disparity … any action that rolls back coverage … only widens that gap,’’ said Corey Wiggins, state health chair for the Mississippi NAACP and director of the HOPE Policy Institute, a public policy think tank based in Jackson. “We should be working to strengthen policies that ensure access to care rather than limit care.’’
Black men are more likely than their white counterparts to suffer with chronic conditions like obesity, cancer and diabetes.
Black men are less likely to have a regular doctor or health insurance, according to a 2012 report by the Kaiser Family Foundation, which examined the disparity. The report found that 15.7% of white men were uninsured, compared with 28.8% of black men.
Medicaid expansions under the 2010 Affordable Care Act made many more men eligible for coverage, increasing their access to providers and medication, health experts say.
Because of that, they will be especially vulnerable if Medicaid expansions are rolled back, said Marc Morial, president of the National Urban League.
“Any effort to restrict the expansion of Medicaid will have a detrimental, negative and devastating effect on African Americans, particularly on African-American men,” he said.
Morial said health care legislation should also address broader social issues, including health education and poverty.
“Health care disparities is a complicated subject and I don’t think any one bill … would comprehensively address all of the issues of health disparities,’’ he said.
Samantha Artiga, director of Disparities Policy Project and associate director for the Program on Medicaid and the Uninsured at the Kaiser Family Foundation, said under the ACA, some groups, including communities of color, did get more health insurance coverage, but that alone doesn’t address the significant disparities for black men.
“Coverage alone is not going to do it,” she said. “It’s just one piece that will help reduce those disparities.’’
Artiga said other factors, including gaps in income, education, access to healthy food and neighborhood amenities, also “drive differences in health.”
For decades, the Congressional Black Caucus, the Congressional Hispanic Caucus and the Congressional Asian and Pacific American Caucus have teamed to introduce measures to address disparities.
The groups plan to reintroduce the Health Equity and Accountability Act, which would expand resources for minority doctors and nurses and other medical professionals, fund more research and target funds for community-focused programs.
Sponsors, mostly Democrats, acknowledge chances for passage are slim in the Republican-controlled Congress.
“We keep pushing and keep pushing, and who knows, maybe we’ll get it,” said Rep. Robin Kelly, a Democrat from Illinois and chairwoman of the Congressional Black Caucus Health Braintrust.
Kelly said the GOP health care proposals will do little to address disparities.
“I think we will backtrack,’’ she said. “Black men will be left out, but I also think black families in general will be hurt.’’
In May, the Centers for Disease Control and Prevention (CDC) reported some rare positive news regarding health and race: African Americans are generally living longer than in 2000 and the gap between black and whites is closing.
But a history of distrust of government by blacks persists, stemming from scandals, including the 40-year Tuskegee experiment in which government researchers intentionally withheld treatment from African-American men with syphilis.
Wiggins said distrust is just one barrier. He said the high unemployment among black men is a major issue since health coverage is often tied to a job.
Some activists said the responsibility falls on black men themselves.
Michael O. Minor, pastor of the Hill-Hernando Oak Hill Baptist Church in Hernando, Miss., said it has been hard getting black men to sign up for coverage even before the ACA.
“A lot of the African-American men just don’t worry about getting health insurance,’’ said Minor. “I didn’t really expect to see a lot of African-American men jumping to get health insurance because it’s not in our DNA to want to go to the doctor.’’
Meanwhile, there are targeted efforts to address disparity across the South at churches, universities, barbershops and hair salons.
Armed with a four-year grant from the CDC, the Minority Health and Health Disparities Research Center at the University of Alabama at Birmingham launched the Birmingham REACH for Better Health program in 2014.
In partnership with local organizations, the program aims to improve the health of African Americans in the city by addressing key factors in health disparities — nutrition and exercise.
In one effort, a partner works with corner store owners to make space on their shelves for fresh produce.
“This allows community members to have access to fresh fruits and vegetables,’’ said Theresa Wynn-Wallace, the project’s program director. “It’s a learning curve … and our partners had to start small and work their way up to having full displays in each store.’’
Another effort involves physicians giving patients a “prescription to exercise’’ and connecting them to one of the city parks.
A few miles away from the university, more than 400 people registered for the Alabama Baptist State Congress of Christian Education conference. Participants packed classes that focused on diabetes, Alzheimer’s and HIV — issues that disproportionately affect blacks.
“We’re just trying to bring better health awareness to our community,’’ said Dorothy McAdory, who helped coordinate the conference and is the chief administrative assistant to the Rev. Jonathan McPherson, the dean of the congress.
Some had already launched efforts.
In lieu of Bible study at the Mercy Baptist Church in Montgomery, Ala., the church hosts a forum each quarter on issues from diabetes to hypertension to depression. The church also offers more healthy food options.
“We’re looking at the individual holistically as opposed to just looking at the spiritual,’’ said Johnny J. Hollis, Jr., the church pastor. “There has to be a paradigm shift in the way we think about eating. There has to be a paradigm shift in the way we think about exercising.”
Every fifth Sunday at the Faith Missionary Baptist Church in Bessemer, Ala., Darlene Cotton checks the blood pressure of her fellow churchgoers to complement the health topic of the day.
“We’re dying because of a lack of knowledge,’’ said Cotton, a nurse at the University of Alabama at Birmingham and the church’s health care coordinator. “Accessibility is one of the main things… A lot of times, we don’t even know about programs — or ask.’’
Marian Little shocked the congregation at the New Mt. Moriah Missionary Baptist Church last year when she told members the menu would no longer include fried chicken.
“I said we’re becoming health conscience and we won’t have any fried chicken,’’ she recalled. “They said, ‘Fried chicken is gone?’ I said yes, get used to the baked chicken, and they did.’’
The church has also substituted water for sugary drinks and yogurt for ice cream, along with holding exercise classes and stocking the community food pantry with healthy options.
Michael Wesley, pastor of the Greater Shiloh Missionary Baptist Church, which hosted the conference, said churches must step up.
“Clergy cannot just only be concerned about what goes on inside the church, we have to be concerned about the warfare that exist outside the church,’’ he said.
Shiloh started a community garden, hosted a six-week exercise program and offered baked chicken as an option to fried. On Sundays, churchgoers can get their blood pressure checked.
“The idea is to engage your congregation in healthy ministries and healthy lifestyle,’’ Wesley said. “Ultimately, not only your congregation is impacted, but your communities.’’
Contributing: Jayne O’Donnell
Follow Deborah Barfield Berry on Twitter: @dberrygannett