Health insurance crisis termed worse for blacks Conference sees major rights issue

The health care crisis that has left a steadily increasing number of Americans without health insurance has hit blacks much harder than whites -- exacerbating the higher disease and death rates that plague black communities.

It's not just poverty that has forced many blacks to go without health insurance, health officials said yesterday during a national conference at the Johns Hopkins School of Hygiene and Public Health.


Employed blacks whose incomes place them above the poverty level are also less likely than whites to have health insurance because they tend to work for smaller, less stable companies that are hard pressed to provide health coverage, the officials said.

And the recession is putting the health care of many employed blacks in jeopardy as many employers drop company health plans even if they are not laying off workers.


Although the problem appeared too daunting for easy solutions, the 125 people attending the conference seemed to agree that the poor health status of American blacks was a major civil rights issue for the 1990s.

"It is not hyperbole to say that if these inequities were identified in another community, questions of human rights would be raised," said Dr. David Satcher, president of the predominantly black Meharry Medical College in Nashville, Tenn.

The three-day conference, which concludes today, was called the first gathering of leading health officials and advocates to focus not only on the high disease and death rates among blacks but also on differences in health insurance coverage between blacks and whites.

It is being sponsored by the Johns Hopkins School of Hygiene and Public Health, Meharry Medical College and the NAACP Legal Defense Fund.

An estimated 38 million Americans lack health insurance. While the proportion of whites lacking health insurance increased from 12 percent in 1977 to 15 percent in 1987, the ranks of uninsured blacks swelled from 18 percent to 25 percent. The problem was even more severe for Hispanics, among whom 35 percent lacked health insurance in 1987, compared with 20 percent a decade earlier.

"At all income levels, African Americans are much less likely to have private health coverage," Dr. Karen Davis, chairwoman of health policy at the Johns Hopkins School of Hygiene and Public Health, said yesterday. Almost one-quarter of black families with working adults lack private health insurance, she said -- twice the rate for whites.

At the same time, just about every health indicator shows that the prospect of growing up healthy is much poorer for black Americans than it is for whites.

Dr. Howard Kelley, senior public health consultant with the U.S. Office of Minority Health, said Thursday that blacks are more likely than whites to die from accidents, cancer, heart disease, cirrhosis, stroke, diabetes, kidney failure, homicide and AIDS.


No fewer than two dozen proposals aimed at reforming the health care system have come before Congress. Some would preserve private health insurance but outlaw restrictive practices; others would establish a government-based system of universal health coverage; others cover a full range of plans between those extremes.

Many advocates from cities across the country said they favored universal health insurance but wondered whether this was realistic in light of fierce opposition.