DOCUMENT RESUME ED 326 585 UD 026 889 TITLE Now Is the Time: An Action Agenda for Improvi%g Black and Minority Health in Maryland. The Final Report of the Maryland Governor's Commission on Black and Minority Health. INSTITUTION Maryland Governor's Commission on Black and Minority Health, Baltimore.; Maryland State Dept. of Health and Mental Hygiene, Baltimore. PUB DATE Nov 87 NOTE 228p. AVAILABLE FROMMaryland Dept. of Health and Mental Hygiene, Policy and Health Statistics Administration, Division of Policy Analysis, 201 West Preston Street, Baltimore, MD 21201. PUB TYPE Reports - Research/Technical (243) EDRS PRICE MF01/PC10 Plus Postage. DESCRIPTORS *Blacks; Demography; *Health Needs; *Health Promotion; Health Services; Hearinas; Migrant Workers; *Minority Groups; Mortality Rate; Public Health; *Racial Differences; Refugees; State Surveys; Whites IDENTIFIERS *Access to Health Care; *Maryland ABSTRACT This document comprises a report on the disparity between the health status of Maryland's blacks and minorities and the white population. Information was gathered from statewide public hearings at which over 50 individuals and groups representing the general public and health care providers testified. The major finding was that a disproportionate number of black and minority Marylanders died needlessly between 1983 and 1985 from diseases, homicide, or accidents that were either preventable or controllable. Although Maryland has one of the best health care delivery systems in the nation, major improvements are needed if the health status of blacks and minorities is to change. Goals for improvement and priority recommendations are discussed. Statistical data are included on one graph and 13 tables. Brief summaries of the following topics are also included: (1) major ratdal health-related disparities in Maryland; (2) factors contributing to identified racial health disparities; (3) major causes of death and related risk factors; (4) differences in the cultural norms of Anglo-Americans and minorities that may impede health care; and (5) priority goals and recommendations. Lists of the Governor's Commission on Black and Minority Health Task Force members, a national directory of health-related organizations and agencies, and brief discussions of the major health 7-oblems of Native Americans, refugees, and migrant farm workers in Maryland are appended. (FMW) *********************************************************************** Reproductions supplied by EDRS are the best that can be made from the original document. *********************************************************************** NOW IS THE TIME: AN ACTION AGENDA FOR IMPROVINGBLACK MINORITY HEALTH INMARYLAND U.S. DEPARTUENT OF EDUCATION Moe 0 Educeel Research and Imorovenw "PERMISSION TO REPRODUCE THIS EDUCATIONAL RESOURCES INFORMATICIr MATERIAL HAS BEEN GRANTED BY CENTER (EFOC) 6 pus document has teen reorodcced as !..ec. fe A reteued from the person or agar Lisbon CoWkatmgd, C Shner Changes have been made to =prose D Dept" 7f I-teal-if, cu.-e) retsroduchon mighty netipla11 11 Pomts of ue or op.mons stated in !Ms Wet/. rnent do not necesSaray reweSent ofhPal TO THE EDUCATIVUL RESOURCES GERI poscron or coucy INFORMATION CENTER (ERIC)." The Final Reportof the Maryland Governor's Commission on Black & MinorityHealth William Donald Schaefer Governor November, 1987 NOW IS THE TIME: An Action Agenda For Improving Black And MinorityHealth In Maryland IP The Final Report of the MarylandGovernor's Commission on Black and Minority Health William Donald Schaefer, Governor November. 1987 TABLE OF CONTENTS Preface iv Executive Order vii Commission Membersand Staff ix Acknowledgements x Tables, Figures, andExhibits xii EXECUTIVE SUMMARY I I. THE WORK OF THECOMMISSION MINORITY HEALTH II. OVERVIEW OF BLACK AND 3 ISSUES AND PROBLEMS* 3 Who are Maryland'sMinorities? Minority Morbidity Leading Causes of Black and 6 and Mortality Racial Factors Contributing to the 12 Health Disparities 27 References 28 III. KEY COMMISSION FINDINGSAND CONCLUSIONS IV. COMMISSION GOALS ANDRECOMMENDATIONS AND MINORITY HEALTH 33 FOR IMF ROVING BLACK 62 THE "ACTION AGENDA" V. SUMMARY REPORTS 83 Minority Health ManpowerDevelopment 105 Maternal, Child and FamilyHealth 110 to Finance, Access, and IndigentCare Cardiovascular Disease, Cancer, 116 Diabetes, and AIDS 128 Homicide, Suicide andUnintentional Injuries 132 Black and MinoritySubstance Abuse 150' Black and Minority MentalHealth 153 Black and Minority Aging 158 VI. APPENDICES , 4 in The Commission recognizes that- there are few quick -fixes and that significant impro,tements will not occur overnight. However, it is the Commission's strong belief that more can and must be done by public officials, tlealth care providers, private sector groups, minority individuals, and minority communities to worktoWard improving the health of Black and minority Marylanders. At a minimum, Maryland's health care system should be changed to assure Blacks and minorities ready access to quality, appropriate care.Additionally, intensive and widespread educational efforts must be initiated to give Blacks and minorities the requisite skills and resources needed to improve their health status. The State of Maryland has a proven track record of being at the forefront of implementing new and innovative strategies to address complex health issues and problems.Lessening the gaps in health status and access to health services between minorities and non-minorities should prove to be a difficult, but manageable task for a State which has been historically committed to promoting equal access to health care for all. Larry Young Chairman Edward N. Brandt, M.D., Ph.D. Vice-Chairman PREFACE The goals and recommendations contained in this report reflect the healthcare needs of Maryland's Black and minority populations.The Governor's Commission on Black and Minority Health has, over the past twelve months, studied the health care problems faced by Black and minority residents in Maryland; this report contains the results of the work of the Commission. The first chapter describes the approach used by the Commission as issues and problems were investigated. The second section presents an overview of the health status of Maryland's Blacks and minorities and briefly reviews the factors which contribute to the health experience of these populations.The data in this section lay the groundwork formore detailed discussions of major health problems facing Black and minority populations.These problems are addressed in the fifth chapter which is composed ofsummary reports focusing on cardiovascular disease, AIDS, cancer, maternal and child health, homicide, aging,substanceabuse,mentalhealth,medical indigency, and minorityhealth manpower. Each summary report defines the nature of the problem and further details the Commission's findings. The Commission's findings should not surpriseanyone:Blacks and minorities face barriers in obtaining access to health care services, become illmore frequently, and de at younger ages than Whites.The Commission is dismayed at the extent of tne disparities in health status between Blacks and minorities and Whites and, furt,her,is concerned with the lack of programs designed to decrease these disparities.The key Commission findings and conclusions are given in the third chapter of thisreport. The goals and recommendations for improving the health of Blacks and minoritiesare listed in the fourth chapter and subsquently comprisean "Action Agenda." While the Commission has formulated goals and recommendationsto improve the health status of Maryland's most vulnerable populations,it was the consensus of Commission members that further work isnecessary to address the health care problems defined in this report. Due to time, resource, and data constraints, this Commission chose to focus its attention cin several key priorityareas: infant mortality, Black and minority health manpower development,access to primary health care services, and prevention of cardiovascular disease,cancer and AIDS.A permanent Gubernatorial Commission on Black and Minority Healthmust be established to continue the work which this Commission has only started. After reading this report, it should be clear that there isa need to conduct a More rigorous and systematic examination of theprograms and services related to the health status of Blacks and minorities than this Commission was able to do. The recommended permanent Commission should be charged to continually monitor Black and minority health trends and problems, and to facilitate the implementationof strategies which reduce racial disparities in health status and alleviate inequities inaccess to health care services. The work of this time-limited Commission isnow complete. The recommendations presented do not claim to be the definitiveanswers to solving Black and minority health problems. However, they are to be viewedas an important initial agenda for addressing priority Black and minority health problems in Maryland. 5 iv ..-.,. Cxecutibt ;Department EXECUTIVE ORDER 01.01.1986.05 Governor's Commission on Black and MinorityHealth with enhancing the health WHEREAS, The State of Maryland is concerned of all of the Statee citizens; health statue and utilization WHEREAS. Disparities exist in both the of health services betweenBlack, Asian, Hispanic, NatiVe American and other minoritycitizens and white citizens of Maryland; The infant mortality rate forminority citizent of Maryland is 90 percent higher thanthe infant-mortality rate for white citizens; rate for