A Philosopher's Blog

Hearts, Health and Race

Posted in Medicine/Health, Politics, Race by Michael LaBossiere on April 29, 2009

A recent study published in the New England Journal of Medicine revealed that blacks under the age of 50 suffer heart failure at twenty times the rate of whites. The main culprit that is pointed to is hypertension, which leads to the question of why blacks are more likely to suffer from hypertension than whites.

Some reasons are biological. One such factor is genetics-blacks seem to have a genetic predisposition towards hypertension (or greater vulnerability to it or its causes). Also, it has been claimed that blacks are more likely to have hypertension in response to salty diets than whites (although the role of salt in hypertension has been debated by some).  Aside from genetic engineering, these biological factors cannot be altered.

Some reasons are environmental, psychological and social. One factor is that men in general and black men in particular tend to avoid going to the doctor. As such, black men are less likely to be diagnosed with and treated for hypertension. Since hypertension is generally quite manageable, it is hardly surprising that the rate of heart failure among black males would be higher.

Another factor is that black males are less likely to have medical insurance than white males. Someone who does not have insurance is far less likely to go to the doctor to be checked for hypertension and hence more likely to have any hypertension left undiagnosed and untreated. Further, even if a person is diagnosed with hypertension, then there is still the challenge of paying for the treatment and follow up appointments. Since black males tend to be less well off than white males, it is hardly surprising that such a disparity exists.

There is also the concern that racism might play a factor-that white doctors might be more concerned about white patients than black patients. Also, black neighborhoods will tend to be poorer neighborhoods and hence black males will have less access to health care providers.

Fortunately, there are various community organizations that are making testing for hypertension readily available, often at the neighborhood barbershops. While such efforts are both laudable and essential, this situation is yet one more example of how health care in America needs to be improved.

Part of the problem is that while people are willing to pour billions into a socialistic defense program to protect us from terrorists and other human enemies, the same willingness is not there to protect Americans from the greater threat posed by health issues.

If the state is obligated to protect its citizens, then it should do so against all threats-be that threat  hypertension or Hezbollah, Al Qaeda or Alzheimer’s.

These need not be done using “socialized medicine“, but just as each citizen is entitled to the protection of the police and armed forces, so too should each citizen be entitled to protection against disease and illness. After all, a person is just as dead whether they are blown up by Al Qaeda or die of a heart attack arising from untreated hypertension.

Of course, it might be argued that people should be left to fend on their own when it comes to health care. The challenge is, of course, to argue that this is the case while at the same time holding that the military and police should protect all of us. Of course, a person can be consistent and argue that people should be on their own for everything-let the market decide who dies of hypertension and who gets protected from Al Qaeda.

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9 Responses

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  1. kernunos said, on April 29, 2009 at 3:46 pm

    I knew it would be blamed on racism somewhere. If you would have been a lawyer instead of a professor you would have been stinking rich years ago. More personal responsibility please.

    • Michael LaBossiere said, on May 1, 2009 at 6:44 pm

      Racism is, at most, only one factor among several. The main factors seem to be biological and social (non-racist).

      Racism really is a factor. We didn’t see it that much growing up in Maine; mainly because almost everyone in the state was white. But get around and you’ll see it at work.

      Yes, people should take responsibility for their health: exercise, eat properly, get proper rest, get check ups and so on. I think a good national health care plan would be “run, damn you, run!”

      • kernunos said, on May 1, 2009 at 10:45 pm

        What about cultural?

      • Michael LaBossiere said, on May 3, 2009 at 6:42 pm

        Yes, culture does play a role. American culture certainly encourages unhealthy living in many ways. Fast food, lack of exercise and so on all lead to serious health problems.

  2. Dave said, on April 30, 2009 at 12:38 pm

    What would a non-socialist defense program look like?

  3. kernunos said, on April 30, 2009 at 9:06 pm

    Not sure where you are going with this Dave?

    • Dave said, on May 1, 2009 at 2:28 pm

      I have no direction in mind. I thought Mike’s reference to a socialist defense program was interesting, but I was unable to visualize an alternative. I was hoping someone might be able to speculate on what a non-socialist defense program would look like.

      • Michael LaBossiere said, on May 1, 2009 at 6:49 pm

        Here are some historical models:

        1. Non-funded militia: citizens act as soldiers, but buy their own equipment and are unpaid. See, for example, some of the Greek warriors.
        2. Mercenary armies: a European favorite for a while-you buy your own private army. But, as Machiavelli argued, this is a bad option. Today we call them “contractors” and it is still a bad idea.

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