By Aurelio Rojas - arojas@sacbee.com
Published 12:00 am PST Monday, November 5, 2007

Members of the Legislature's African American, Latino and Asian caucuses convened a town hall meeting in a show of solidarity on the eve of last week's hearing into Gov. Arnold Schwarzenegger's universal health care plan.

"We want to deliver a message to the governor (and) to the entirety of the Legislature that any health care discussion, absent the issue of health care disparities, will continue to undermine the quality of care and life expectancy in communities of color," state Sen. Mark Ridley-Thomas said at the outset.

During the past year, the Schwarzenegger administration has held more than 1,000 meetings with stakeholders as it developed its health care plan. But Ridley-Thomas, chairman-elect of the Legislative Black Caucus, said the role of race and ethnicity in the distribution of health care resources has been "conspicuously absent from the discussion."

"We wouldn't be here tonight, in fact, if we had been adequately heard," the Los Angeles Democrat said.

It was a concern that Assemblywoman Karen Bass, who spearheaded the Black Caucus' study, "The State of Black California," delivered the day after Tuesday's town hall meeting to Kim Belshé, Schwarzenegger's secretary for health and human services.

Belshé told Bass, D-Los Angeles, that "far too many" of the 6.7 million uninsured Californians live in communities of color.

"Getting an insurance card in everyone's pocket is an important piece of the problem," Belshé said. "At the same time, we all know that the insurance card isn't enough."

Belshé said that's why the governor's plan places "a high priority on prevention, wellness and health promotion."

But health care experts who testified at the town hall meeting said the state also must provide resources to reduce disparities in health.

They came armed with statistics from the U.S. Centers for Disease Control and Prevention to support their contention that the inequitable distribution of resources has resulted in wide differences in the incidence of diseases and other adverse health conditions. Among the findings:

• African Americans are 13 percent less likely to undergo coronary angioplasty and one-third less likely to undergo bypass surgery than whites.

• The length of time between an abnormal screening mammogram and the follow-up diagnostic test to determine whether a woman has breast cancer is more than twice as long for Asian American, black and Latino women as for white women.

• Among preschool children hospitalized for asthma, only 7 percent of black children and 2 percent of Latino children, compared with 21 percent of white children, are prescribed routine medications to prevent future hospitalizations.

Dr. Richard Williams, a professor of medicine at the University of California, Los Angeles, and author of "Eliminating Health Care Disparities in America," said the reasons for these differences transcend economics.

"The simple explanation for health care disparities is just plain racism," said Williams, founder of the Association of Black Cardiologists.

"Whatever proposal comes out of the governor should speak to completely redesigning the way we do primary care medicine in this environment."

Dr. Randall Maxey, past president of the National Medical Association, said, "People of color – rich and poor – are subject to second-class medicine."

"Our medical system is built upon a majority culture and it presumes that we're all created equal, and that happens not to be so," Maxey said. "Because of genetic polymorphisms (and) cultural differences, we react differently."

Popular culture, Williams said, is recognizing these differences. A recent episode of the television drama "ER" dealt with Brugada syndrome. The genetic disease, which disproportionately afflicts Asians, increases the risk of sudden cardiac death.

Assemblywoman Mary Hayashi, D-Castro Valley, noted that while Asian Americans are often portrayed as "the model minority," they have health problems that have been overlooked.

"Elderly Asian American wo-men have the highest suicide rate in the country," said Hayashi, former president of the National Asian Women's Health Organization. "We know that when Asian women are born here, their diet and environment is equivalent to the Caucasian population."

Hayashi has introduced a bill, AB 330, that would require the state to develop a report to assess the level of health disparities.

Assemblyman Joe Coto, D-San Jose, chairman of the Latino Legislative Caucus, said he had attended a hearing on diabetes in Los Angeles the day before and was alarmed at how fast the disease is spreading in minority communities.

"The State of Black California" concludes that African Americans who live in Sacramento fared the best in the education index but were at the bottom in the health index.

Many African Americans in Sacramento don't have health insurance and depend on clinics such as the county health center in Oak Park for care.

Betty Williams, the Sacramento branch president of the NAACP, which helped to organize the town hall meeting, said, "You'd think there would be a link between education and health care."

"But discrimination and racism have a lot to do with disparities," Williams said. "That's why we don't get the testing and medication other people get."