It's that time of year again in Washington. The cherry trees
blossom, tourists flock to the National Mall -- and Congress begins
negotiations over the federal budget.
Near the top of this year's agenda are cuts needed to address
the deficit, and various healthcare programs are undoubtedly under
discussion. But if Gallup's March 7-10 poll* is any indication,
healthcare probably isn't the best place for major cuts. When
presented with a list of 12 social, economic, and political
problems facing the country, Americans are most likely to choose
"the availability and affordability of healthcare" as the issue
they worry about most. Six in 10 Americans (60%) worry about this
issue "a great deal." Social Security is a distant second with 48%
worrying a great deal.
That sentiment is reflective of a speech Franklin Delano
Roosevelt once gave. "The success or failure of any government in
the final analysis must be measured by the well-being of its
citizens," Roosevelt argued. "Nothing can be more important to a
state than its public health; the state's paramount concern should
be the health of its people." Roosevelt would be pleased that
overall health status and life expectancy in the United States have
improved dramatically since the 1930s -- but he'd also recognize
that these improvements haven't lessened public concern about the
nation's healthcare system.
Who Is Concerned About Healthcare?
A majority of Americans in almost every group worry a great deal
about healthcare availability and cost. But an aggregate of the
last four years' data on this question**, which allows for a more
in-depth look at subgroups, shows black Americans are more
concerned than whites.
Blacks have good reason to be more concerned than whites about
healthcare in the United States. The Office of Minority Health at
the U.S. Centers for Disease Control and Prevention reports:
- The infant death rate for black Americans is more than double
that of whites.
- The death rate for heart disease is 40% higher for black
Americans than it is for whites.
- The death rate for cancer is 30% higher for black Americans
than it is for whites.
- Black American women, despite having almost as high a
mammography screening rate as white women, have a higher death rate
from breast cancer.
The medical journal Health Affairs recently published
an article titled, "What If We Were Equal? A Comparison of the
Black-White Mortality Gap in 1960 and 2000." The authors have found
that the gap between black and white mortality rates changed little
between 1960 and 2000, and the gap actually grew worse for black
infants and black men over the age of 35.
Bottom Line
When it comes to the United States' black population, it appears
the U.S. government is not living up to FDR's ideal. Blacks are
extremely likely to say they worry about access to healthcare --
and their worries are justified. Even as the push to reform Social
Security grabs headlines, the Medicare system is approaching
crisis, as is Medicaid in many states. How will legislators
respond? Will they aggravate the problem for short-term budgetary
gain, or lead the charge toward reforming healthcare and protecting
public health? Where black Americans are concerned, the issue is
one of social justice -- and for many a matter of life or
death.
*Results are based on telephone interviews with 1,004
national adults, aged 18 and older, conducted March 7-10, 2005. For
results based on the total sample of national adults, one can say
with 95% confidence that the maximum margin of sampling error is
±3 percentage points.
**Results are based on telephone interviews with 4,023
national adults, aged 18 and older, conducted March 2002 to March
2005. For results based in the sample of 3,406 whites, the margin
of sampling error is ±2 percentage points. For results based
in the sample of 253 blacks, the margin of sampling error is
±7 percentage points.
