Earlier this summer I was privileged to take part in an exciting announcement and demonstration of a new telemedicine program that will enable doctors in Columbia to screen diabetics in rural areas of the state for retinopathy.  This eye condition affects 40% of diabetics, but if treated early, 90% can save their vision.  Diabetes strikes 1 in 4 minorities in South Carolina and we lead the nation in amputations per capita.  Those in rural areas often don’t receive proper health care and treatable conditions like retinopathy go undiagnosed until it is too late.  Let’s look at some other facts:

• Strokes: South Carolina is first in the nation for the rate of deaths due to strokes, and African Americans are nearly twice as likely to die of stroke than are whites
• Heart Disease: Black females are nearly twice as likely to die of heart disease than are white females.  African American men are almost one and a half times more likely to die of heart disease than are white men.
• Cancer: Black males in South Carolina are more than three times as likely to die of prostate cancer than white males.  African American females in this state are nearly twice as likely to die of breast cancer than white females. 
• AIDS: African Americans make up 30% of the state’s population and 78% of all new HIV cases reported in 2000. 
• Infant mortality: Black infants are more than twice as likely to die before their first birthday than white infants.

The reasons for the disparities are tri-fold: access, insurance and education.  With many African Americans, especially in rural communities, getting to a doctor’s office is difficult.  Lack of transportation, time off from work, or child care can all be obstacles to getting adequate preventive health care. 

         Obviously a lack of medical insurance is a major contributor to the number of needless emergency room visits.  The Kaiser Family Foundation estimates that at least 26% of African Americans under 65 are uninsured in our state.  The South Carolina Primary Health Care Association, which includes 18 rural and inner city community health centers reports 33% of its patients are uninsured. 

        A lack of education also contributes to these health disparities.  Sixty-four percent of blacks are overweight or obese in South Carolina.  Approximately 83% of African Americans in the state are at risk for health problems related to lack of regular and sustained physical activity.  And 76% of the black population report eating fewer than five servings of fruits and vegetables per day. 

        I was pleased to host a Listening Session on Health Disparities sponsored by the Congressional Black Caucus at the Medical University of South Carolina in Charleston last June.  A number of others will take place around the country over the next year.  The information collected will be compiled in a report and will hopefully provide the impetus for legislation to address health disparities.  I would like to see any effort in Congress include universal health care coverage.  That is the single most important component to insure that all citizens can see a doctor regularly.  More must still be done at home. 

       The new telemedicine technology that will allow diabetics to have regular eye screenings is a cost-effective approach to addressing priority underserved needs.  This federally supported program is a small step in the right direction, but the needs are great and programs like this are few and far between.  Without more immediate and widespread attention, the quality of life gaps related to health will only continue to grow. 

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