Indianapolis Recorder, Indianapolis, Marion County, 25 October 2002 — Page 31

FRIDAY, OCTOBER 25,2002

THE INDIANAPOLIS RECORDER

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The politics of medicine affects care of Blacks

By DR. NATALIE CARROLL The adage that “everything is political” could not be truer in today’s fluctuating health care environment. New technology, an aging population and managed care have dramatically changed the face of medicine in recent years, making politics more important than ever. In my view, politics involves making decisions that determine the allocation of time, resources, energy and attention generated toward specific issues. Whether on a local, national or international level, political decisions impact the way we live — and medicine is not immune from the process. Frankly, I don’t quite “get it” when people say that they are not political. After all, political decisions dictate our quality of life and our direction for the future. People who speak the loudest (the squeaky wheel) help propel their issues and interests to the forefront. Those of us concerned about changing the health care system — and goodness knows, change is desperately overdue—must become more vocal, active and passionate about the need to reform the provision of health services. Certainly, health care is an issue that affects all of us if not now, then most inescapably in the future. We or our loved ones will no doubt have to confront health-related issues that may involve basic medical services, health maintenance organizations (HMOs), insurance premiums for the self-employed and small business persons. Medicare and Medicaid, assisted living, long term care, experimental surgeries, or the use of new medicines and technologies. Thequestionremains: What kind of political decisions are being made that determine the type of health care services available to you, your family, your neighbors, and your fellow Americans? How informed are you about those decisions? And how informed are your local, state and national political leaders? Receiving quality health care should not be determined by one’s income, employment, place of residence or previous health status. In our democratic society, we easily tout the virtues of accessible and affordable medical care that should be available to all, yet the reality is a far different story. The health disparities that exist throughout our nation are shameful and unacceptable. We know that, nationwide, can-

cer kills African Americans disproportionately. According to the latest figures from the National Cancer Institute, Black men die from prostate cancer at a rate 140 percent higher than white men (52.1 percent compared to 21.7 percent), and Black women have a significantly higher mortality rate from breast cancer — 30.9 percent vs. 23.8 percent for white women. * Eliminating these and other disparities must become a major priority if we are serous about having a fair and quality health care system. Earlier this year a major report released by the Institute of Medicine (IOM) further validated what many of us in the medical community have known for years: that African Americans and other minorities receive inferior health care compared to whites. “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care,” the IOM report concluded that minorities experience lowerquality medical care, which contributes to misdiagnosis, improper treatment, greater disease and premature death. The report found that compared to whites, minorities are less likely to receive appropriate medications for heart disease, undergo bypass surgery, or receive kidney dialysis or transplants. They also are less likely to receive the most sophisticated treatments for HIV, which could delay the onset of AIDS. Conversely, the IOM report found that minorities are more likely to receive the least desirable and most intrusive procedures. For instance, in a study of Medicare beneficiaries, Blacks were three-and-a-half times more likely than whites to have their lower limbs amputated as a result of diabetes. In short, the IOM report substantiated what the National Medical Association has proclaimed for years: that the paucity of Black doctors and the health disparities in Black and minority communities contributes to an environment that produces poor outcomes for Blacks and other minorities. This is not right. It is intolerable, immoral and unethical, and flies in the face of any semblance of an equitable health care system. We must demand that our inadequate health care system be placed front and center on the political agenda on every level-lo-cal, state and national. You may

COMMENTARY

know your elected officials’ position on tax reform or school prayer but what about their position on Medicare and Medicaid, prescription drugs, funding for cancer or diabetes research, anti-smoking campaigns, mobile mammogram units and low cost preventive screenings? Do your political representatives understand the need to overhaul or amend the current system of managed care that has contributed to higher prices and marginal service? Do they advocate tort reform and other initiatives that would reduce physician insurance rates, and in turn lower patient costs? What are their views about subsidized preventive care screenings or a patient’s bill of rights? Have they proposed legislation or are they supportive of policies that would address any of the concerns related to the inequitable provision of health care? These are some of the questions that we must ask our elected officials and political candidates. We must let them know that the topic of health care is of paramount importance. And we must insist on the broad implementation of measures and policies aimed at closing the gaps in health care delivery. So I urge you to write, call, fax, e-mail—communicate vigorously and consistently with your elected representatives and political candidates. Let them know of your concern about reducing health disparities and making our health care system more equitable. Leam their positions on these critical issues. And then vote accordingly. One of the most powerful weapons for change is still through the ballot box. Every missed opportunity to vote is a slap in the face to those who sacrificed, suffered and died for this crucial civil right. It is critical to become engaged and in- j

volved.

Unless we speak out and insist that the reform of health care ser- _ vices be placed prominently on the political agenda, the medical divide will only grow wider and more problematic. And that is aprescription for disaster that does not bode well for any of us. Dr. Natalie Carroll is president of the National Medical Associa-1 tion. She also is president and medical director of the Regional Physicians’ Network in Houston.

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Body sculpting expert offers teens tips on muscle toning

Special to The Recorder A new survey published recently in the Journal of the American Medical Association (JAMA) shows that obesity continues to increase dramatically for Americans of all ages. According to the new data, 15 percent of those 6-19 years old, 9 million children and teens, are overweight or obese. Continuing research shows that the best way to control weight is to combine healthy eating with sufficient exercise. Many young men look to weight training to help them bum fat while building lean muscle tissue, but some people worry that lifting weights may harm growing bodies. James Villepigue, a certified trainer and author of the best-selling book The Body Sculpting Bible for Men (Hatherleigh Press, 2001), offers this advice for youngsters who want to start an exercise program. “At what age a teen-age boy can start working out with weights has always been a topic of debate. Some people say that weights should not be touched until after all of the growing is done or else you could affect the growth platelets and stunt your growth. Others say it is OK to start lifting weight at an early age. “Based on the latest research on this subject, I believe that youngsters — anybody less than 12 years old — are better off doing exercises with just their body weight.” Villepigue recommends these exercises for a youngster’s program: running, dips, push-ups, pull-ups, chin-ups, crunches, leg raises, and squats, lunges and calf raises with no weight

Depending on age and motivation, two to five sets of each exercise for the maximum amount of repetitions possible is sufficient. There should be 30 seconds of rest between exercises, and they should be performed three times a week. An additional 15-20 minutes of running on a rest day is enough for anyone who wishes to start an exercise program before the age of 13. Thirteen-year-olds can start woricing out with weights, as long as the weights are light enough to allow 20-30 reps per set. They should basically follow the same program described above with the same set, repetition, and rest scheme. At this point, they can also add the following dumbbell exercises: dumbbell curls, dumbbell overhead triceps extensions, and lateral raises. In addition, dumbbells can also be used to perform lunges, squats and calf raises. Continue this program for the next two years. Fifteen-year-olds can start increasing the weight they lift, but should stay within 13-20 reps. For the next two years, they should concentrate on perfecting their exercise technique and form. They must only increase die weight when they can do over 20 repetitions easily, ’Teens under 18 should not use any fancy weight training techniques or go to absolute muscular failure,” Villepigue warns, “since there is still some bone growth and development occurring in their bodies. Remember, strenuous and heavy weighted exercise can interfere with the growth process, so keep it simple.” “After 18,” he adds, “you can start going heavier in weight with no problems; by then all of die growth platelets, bone and joint structure should be fully developed.”

Preparing a conscious

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