Beyond Medicine .....To Good Health                                                                       21st Century Health                                               COSMIC INTERNATIONAL HEALTH NETWORK                                                               "THE WEALTH OF HEALTH” INTRODUCTION America is in trouble. This is the first time that Americans are faced with 3-4 generations of family members living and in need of health care. Americans rank 42nd in life expectancy among industrialized nations while they spend 1.6 trillion dollars annually on health care.They rank 47th in infant mortality. The expenditures will surely double within the next 5 years when the 42 million uninsured, the immigrants population, the “baby boomers” and the military wounded hit the role of those who will be receiving care. We are presently awaiting a flu pandemic. It is not a matter of whether it will occur but when. It is estimated that 3,000,000 people may be infected and 60,000 may die as a result of this event. There is presently an epidemic that will cause a much higher rate of morbidity and mortality than that of the flu pandemic for years to come. It is obesity. It has been shown that in Mississippi the obesity rate among adults is 30 %. There are at least the same numbers of adults who are over weight. One unpublished study suggests that children have a similar distribution. It is projected that 50 % of the Mississippi adults will be obese within 10 years. There are 600,000 people in Mississippi who are not insured and, 600,000 people on Medicaid... Diabetes, Hypertension and Cancer rates are higher in the severely obese. Therefore, the cost of this epidemic will be staggering. The cost in human capital for production will be significant. In fact and in truth, if the country wanted to change its world ranking, all it would have to do is to improve health of its African-American citizenry. If the health of the African- American community is not improved, the health and other socio-economic rankings of America among the industrialized nations will continue to be depressed. African American health ranks lowest in the country along with their median family incomes. There is a cause and affect relationship associated with these conditions. Many black Americans seek primary health care in the emergency departments. I am a surgeon and Emergency Department physician. I have never seen a blood pressure taken on a child in the Emergency Department with a conversion chart, which is the only way that children can be accurately assessed according to the American College of Pediatrics . Therefore, we don’t know the rate of hypertension in children. In a study that I did on middle school students, I found 6% of the children in the study had undiagnosed hypertension and 6% had undiagnosed abnormal glucose tolerance curves. What is known is a child has a 14 fold chance of having a cardiovascular event as an adult if that child has the metabolic syndrome, which is a combination of obesity, hypertension and diabetes. The problem with African American heath is that it has always lagged behind in improvement. For example, the rate of syphilis and other sexually transmitted diseases are rising in Mississippi predominately in counties with black majorities. Infant mortality is rising among black children but continues to decline among white children. Heart disease has improved among both groups but lags among blacks. The death rate from cancer of the breast and prostate is higher among blacks than whites. Studies have shown that this is the case even when adjustments have been made for variables such as insurance and income. The variables that were a part of the original disparities studies done in 1998 by President Bill Clinton's Department of Health and Human Services included access, availability, quality and cost of health care goods and services delivered to the African-American community. These variables were found to be inadequate to support good health in the African American community. The data collected during the study was a self fulfilling prophesies. It proved what was obvious. Health and healthcare among African-Americans, or any other minority group, has never been a priority among white power brokers in this country. The country’s number one priority has been to build an empire. This means excess capital and cheap labor. Slaves provided cheap labor. They were worthy of care like domestic animals when they served this purpose. After slavery, blacks were required to acquire health care as they acquired other essential goods and services. Their efforts at best were found to be totally ineffective in maintaining or improving health and at worse, no health care was available. From the end of the civil war through the early 1920’s, American health was under the purview of physicians, particularly, those involved in public health. It was at this time, immunizations were found to be successful in preventing such diseases as diphtheria and small pox. Ironically, immunizations were described in use in Africa some 200 years prior to this time. The germ theory had been developed and it’s importance exploited to create clean water and sanitation. Medicine was practiced as an apprentice training program. There were any number of people practicing some form of healing. There were osteopaths, homeopaths, drug vendors, chiropractioners and others who held them selves out as healers. These people had the opportunity to be taught by a medical mentor. In 1901, medical professionals begin to organize and set the standards for the training of physicians. There were less than a dozen medical schools that accepted black students for training. The AMA was established as the trade organization responsible for representing physicians at the state, local and federal government level. The AMA set the standards for medical school curriculums, the number of years of training needed to complete the study and the establishment of licensure laws to practice medicine in the states. The Federal government did not get directly involved with health care until the Great Society initiatives of Lyndon Johnson came on line. These initiatives only dealt with health care payments and not quality, availability and accessibility. Availability and accessibility were spillover benefits of a payment system for demand of health care goods and services and did not represent a right of every American to have good health care. Therefore, if an American citizen could not pay for health care goods and services, those products are not readily accessible to that citizen. The above are some of the reasons that a another type of health attititudes must emerge Black physicians were not allowed to participate in medical disciplines such as surgery, obstetrics and gynecology, that requires touching and manipulating of body parts. Black students who sought advanced training such as residency positions found it very difficult if not impossible to attain these positions. When these positions became available at the black institutions, the residents while traveling long distances to get the training needed, often found that living accommodations were not available. They lived with friends, in public places such as YMCA’s and slept in their cars if no other options were available to them. Black Americans have not been able to close the provider availability gap to the present time. The State of Mississippi, for instance has had chronic health manpower shortages with counties being medically underserved for years. The state has recently made a tacit attempt to address the problem by suggesting that the University of Mississippi should increase the size of the entry classes to it’s medical school. The above are some of the reasons why a different type of health attititudes must emerge in order to improve the health of all citizens in America especially those of African decent. These attititudes must be evidence based. Whatever additional studies reveal, information will be the foundation upon which any 21 century health improvement strategy will rest.                                                                         Return To Main Screen