Left I on the News

Once again we are reminded that health insurance is not the same as health care. A new study of Californians (i.e., not comparing Californians to, say, residents of Mississippi) gives some shocking numbers:

Black men are 40 percent more likely to die of lung cancer than white men. Smoking or tobacco use can't explain this statistic because blacks and whites in the state have fairly similar smoking rates. Instead, research finds that blacks are less likely to survive lung cancer because it is diagnosed at more advanced stages. But what's most disconcerting is that even when diagnosed at the same stage, blacks are less likely to receive the aggressive level of treatment that whites receive. This raises questions about the quality of care - not just access to it.

A similar story emerges when we look closely at treatments for heart disease - the state's leading killer and the largest contributor to the disparity in black/white life expectancy. Socioeconomics cannot explain the difference. Compare a black man and a white man with the same education and income levels, same lifestyle and behavior, same health insurance, and even the same health care setting. Epidemiological and health care research shows that the black man is less likely than his white counterpart to receive the same level of routine diagnostic procedures for heart disease, including angioplasties and cardiac catheterizations, and less likely to receive recommendations or referrals to heart disease specialists.

The reality is that despite impressive gains in longevity over the years, blacks continue to have far shorter life spans than any other racial or ethnic group in the state. And it's not all about insurance coverage. The average black man in California can expect to die about seven years earlier than his white counterpart, despite having very similar rates of insurance coverage.