Doctor John Kauh, an oncologist at Grady Memorial Hospital, notes in the Times article that part of the problem is deficient early screening, particularly among low-income and African-American patients.  He observes that this is sometimes due to a lack of health insurance or social and family support.

Recent news articles indicate that the Affordable Care Act provides greater access to health care for millions of Americans.  However, it appears that something more than a new law is needed to bridge the gap.

Doctor Kauh noted that “many hospitals do not accept patients who cannot pay for care or who have public insurance, and those who do are overburdened with sick, needy patients.”  The doctor proposed the use of more “patient navigators” at the “community level and the hospital level to promote easy access and navigation to proper care.”

The Los Angeles Times highlights America Bracho of the Latino Health Access, who works at the community level training community workers to teach their neighbors and friends how to be healthier.

These articles strongly indicate that equality in health care requires a combination of improved legal access and social support.

Between 2007 and 2010, poverty rates among Latino children increased (6.4%) at a greater rate than the rates of black children (4.6%) and white children (2.3%).

Although the largest group of poor children is Latino children, the nation’s highest child poverty rate is among black children.  39.1% of black children live in poverty compared to 35% of Latino children and 12.4% of white children.

The report states that 39% of Latinos and 68% of African-Americans live within 30 miles of a power plant.  According to a survey of 1,000 Latino voters nationwide, 42% had suffered personal health problems caused by environmental quality issues where they lived.

The report found that various factors, including a lack of health insurance (32.4% of Latinos lack health insurance increasing the number of emergency room visits in the absence of primary care), poverty-level wages (40% of Latinos workers earn poverty-level wages), work conditions (greater risk of developing health conditions from ground-level ozone because of increased exposure to pollutants as a result of working in construction and agriculture), and language barriers, aggravate the health risks of air pollution.

Latinos are three times more likely to die from asthma than other racial groups.  As of 2008, 4.7 million Latinos had been diagnosed with asthma.

According to the report, children suffer the highest risk of developing health conditions from air pollution because their lungs are still developing making them more vulnerable to serious and permanent health damage.  One in 10 children in the United States has asthma.  The prevalence is higher for Hispanic children, particularly Puerto Rican children with one in five suffering from asthma.   The report noted that in New Jersey, a Latino child is one and a half times more likely to be hospitalized for asthma and visit the emergency room than a non-Latino child.

The Latino community is a critical voting bloc.  Latinos are the nation’s fastest growing population group and the youngest (median age of 27 years old).  Latinos constitute 16.3% of the U.S. population, 37.6% of the California population, 37.6% of the Texas population and 29.6% of the Arizona population.  25% of Latinos and 27% of African-Americans consider air pollution a very serious health threat compared to 13% of whites.

Based on HDI scores, the report sorts residents into “Five Californias”.  Only  1 % make it into highly privileged  “Silicon Valley Shangri-La” with a 9.35 HDI score.  By contrast, 38 % of residents occupy “Struggling California”, a group at 4.17 on the HDI whose members are found in the Central Valley, Inland Empire and swaths of Northern California and whose hard work never leads to security or sustained well-being.  Faring worst of all is “The Forsaken Five Percent” at 2.59 on the HDI.  The Forsaken, who are mostly Latino and African-American  reside in impoverished Los Angeles neighborhoods and areas of the San Joaquin Valley and face extremely limited opportunities and choices.  Interestingly, one third of the Shangri-Las and one third of the Forsaken are foreign-born.

The report’s findings point up stark economic, racial and gender disparities including:

• Just 100 of California’s nearly 2,500 high schools account for half of the state’s dropouts.
• Men earn more than women in every racial and ethnic group.
• A gap of $58,000 in annual earnings of the typical worker separates the state’s top wage earners in the Santa Clara–Cupertino, Saratoga, Los Gatos area (about $73,000) from the lowest earners in the LA–East Adams–Exposition Park area (about $15,000).
• California’s Latina women earn the least:   $18,000, which is about what  the typical American worker earned in 1960 half a century ago.
• There is a 15.3 year life expectancy range across neighborhoods with the high and low— Newport Beach/Laguna Hills area (88.1 years) and Watts (72.8 years)—in the same metropolitan area.

There are some report findings that  some readers may find counterintuitive, including the fact that California’s overall life expectancy at 80.1 years is one and a half years longer than the national figure and that foreign-born Californians live an average of four years longer than native-born residents.

“Given the current budgetary environment in California, there could be no better time for this nonpartisan, fact-based tool to break down the silos, look at who is thriving and who is merely surviving, and identify the most strategic levers for change,” says report co-author Kristen Lewis.  In a recent piece on the report, Sacramento Bee political columnist Dan Walters warns that failure to take appropriate action on the findings will relegate the Golden State to the “two-tier” haves and have-nots California that he predicted in his writings of 25 years ago.

The report’s recommendations include fixing the broken governance system, targeting high drop out high schools, reducing residential segregation, reducing the earnings gender gap and addressing the African-American health crisis.

We encourage California readers to examine the full report and see how its findings, maps and other demographic information might be used in advocacy.

From October 2009 through June 2010, an online survey was conducted regarding the treatment of LGBT elders in long term care facilities.  Over seven hundred people responded to the survey, including over two hundred people who identified themselves as being LGBT and elderly.  A majority of the LGBT elderly respondents reported a belief that long term care facility staff would discriminate against an LGBT elder who was open about their sexual orientation and that there was a 50% chance of long term care staff openly abusing or neglecting the LGBT elderly.

A report regarding the results of the online survey presents the following findings:

• Only 22% of respondents said they could be open with facility staff
• 89% of respondents predict that staff would discriminate
• 43% of respondents reported 853 instances of mistreatment
• 93 respondents reported restrictions on visitors
• 24 reported denial of medical treatment
• Many highlighted the importance of health-care power of attorney

The report also points to a wide array of policy remedies that could be enacted to support LGBT elders better and improve the facilities where they reside.  The report’s recommendations are directed toward policymakers as well as long-term care providers. The survey, website and the report were prepared by the National Senior Citizens Law Center in collaboration with Lambda Legal, National Center for Lesbian Rights, National Center for Transgender Equality, National Gay and Lesbian Task Force and Services & Advocacy for GLBT Elders (SAGE).  Survey results, comments and personal videos from LGBT older adults can be found as well as profiles of the authors at www.LGBTLongTermCare.org.