working poor—people who have
jobs but don’t have the option of
receiving health insurance or can’t
pay the co-payments—who really
fall between the cracks.
The greatest impact on these
individuals is the lack of preventive
care. “An early stress test for preven-
Although these findings point to
people of color, especially blacks
and Latinos, as being profoundly
impacted by their class status, Dr.
Ichiro Kawachi, director of the
Harvard Center for Society and
Health, states in his report, “Health
Disparities by Race and Class: Why
Younger Than 65 Younger Than 65
40% NA/AN 40%
35 35
30 Latino
30
25
25 Latino Black
20
20
15
15 NA/AN
10 White
10 Asian/PI
5
5 White
00
1995 2000 20031995 2000
NO TES: Asian/PI refers to Asians and Pacific Islanders. NA/AN refers to Native Americans and Alaska Natives.
Latino includes Latinos of any race. Source: Health Chartbook 2005, U.S. Department of Health and Human Services
Black
Asian/PI
2003
tive measures may cost $1,000.
However, if they don’t get earlier
testing because of financial reasons,
they may get a heart attack, and
now, their condition is at a later
stage and there’s more damage to
the heart. Now their costs are over
$25,000,” says Dr. Ketan Shah,
chief of primary care and medical
service at VA Medical Center in
Battle Creek, Mich.
“People in upper classes—those
who have a good education, hold
high-paying jobs, and live in comfortable neighborhoods—live longer
and healthier lives than do people in
lower classes, many of whom are
black or members of ethnic minorities,” stated a recent study in The
New England Journal of Medicine
titled “Class—The Ignored
Determinant of the Nation’s Health”
by Dr. Stephen L. Isaacs, former professor of public health at Columbia
University and a practicing attorney.
Both Matter,” that using race as a
proxy for class is inaccurate. “The
majority of the poor in the United
States ( 68 percent) are white …
Low-income black Americans have
more in common—as far as their
2000 to more than 37 million in
2005, a 15 percent increase, to what
now is 13 percent of the U.S. population. Two of five adults—an estimated 77 million people age 19 or
older—have medical debt or struggle
to pay off medical bills, according to
The Commonwealth Fund, a foundation for health research. Unfortunately, the gap only seems to be
widening as the costs for healthcare
premiums continue to rise and
wages of low-income jobs stagnate.
“To a large extent, healthcare disparity is based on class,” says Shah.
“If a minority is a millionaire, he will
get healthcare if he needs it. There is
a disparity if they don’t have enough
money. When your biggest worry is
putting food on the table, you’re not
thinking about preventive care.”
Not only do “people in lower
classes die younger and are less
healthy than people in higher classes,” but there are several behavioral
discrepancies such as smoking, eating habits and lack of exercise to
go with less-than-average health-insurance coverage, finds Isaacs. His
research also found that white men
earning less than $10,000 a year
were 1.5 times more likely to die
“If you think you may die by 25, you
probably have a limited interest in avoiding
cancer later on in life.”
Newt Gingrich, former Speaker of the House
risk of heart disease is concerned—
with low-income white Americans
than with middle-class or affluent
black Americans.”
Life in the Gap
Healthcare costs continue to rise, as
do the number of Americans living
in poverty. According to the U.S.
Census Bureau, the number of poor
persons rose from 31. 6 million in
prematurely as those earning
$34,000 or more.
Poussaint and Newt Gingrich,
former Speaker of the House and
founder of the Center for Health
Transformation, believe that the
healthcare gap is augmented by the
cultural disparities that exist in a
person’s or a communities’ class.
Poussaint points out that a person
coming from a lower-status environ-
