Health Care for African Americans: How to Deal With the Differences

Two winters ago, the members of CONSULTANT'sEditorial Board met for 3 days with the journal'seditorial staff to brainstorm ways in whichCONSULTANT might best address the educationalneeds of primary care clinicians. One idea in particulargenerated unanimous enthusiasm: an entire issuedevoted to the health care problemsand needs of African Americans.Unlike so many ideas that seemterrific during an ivory-tower brainstormingsession--but far less appealingon return to "reality"--enthusiasmfor this one has not waned.In fact, the concepts developed 2 wintersago are reflected in the contentsof the issue you now hold in yourhands.THE SCOPE OF THEPROBLEMAfrican Americans currentlymake up only 12.3% of the US population.Yet they bear a disproportionateburden of the morbidity andmortality associated with many diseases.For example, African Americansaccount for nearly 16% of ageadjusteddeaths from cardiovasculardisease; 19% of deaths from prostatecancer; 22% of all deaths fromdiabetes; and 48% of deaths fromHIV/AIDS.¹ Nearly one quarter ofthe infants who die each year inthis country are African American.¹The diseases listed above and anumber of others--such as asthmaand sarcoidosis--contribute to considerable excessmorbidity among African Americans.Why do common illnesses extract such a heavy tollon black Americans? The reasons are diverse and complex--and clearly outside the scope of a single issue devotedto addressing the health care disparities that existbetween blacks and whites. But whatever the reasons,there is much that primary care clinicians can do now tohelp improve the health care--and ultimately the health--of their African American patients.HELPING PRIMARY CAREPRACTITIONERSMAKE A DIFFERENCESimply increasing awareness ofthe conditions and diseases thatparticularly afflict African Americansis a good start. The current issueof CONSULTANT is dedicated to thisgoal. The content is focused onhealth problems that are especiallycommon in black persons. Forexample, in the following pages, nationallyknown experts discuss suchtopics as:

• Which combinations of antihypertensiveagents are most effectivein African Americans and how to improvepatient compliance with theregimen.
• How best to manage diabetes inyoung black patients.
• Tips on identifying skin disordersin dark-skinned patients.
• Strategies to control exerciseinducedasthma.

I am pleased to have takenpart in the creation of this specialissue of CONSULTANT, and it ismy hope--and that of the otherboard members--that you will share our appreciation forits importance.

References:

REFERENCE:

1.

National Center for Health Statistics. Health, United States, 2002, With Chartbookon Trends in the Health of Americans. Hyattsville, Md: Claitor’s Law Booksand Publishing; 2002.