Panel studies health disparities in minorities
Capitol Report for dailies for week of March 12, 2006
By Jim Campbell
OPA Capitol News Bureau
Oklahoma lawmakers, faced each year with the poor state of Oklahoma's health in general, are being asked to consider what health conditions are like in the minority population and what to do about it. It has not been an easy sell.
Two bills by Sen. Constance Johnson, D-Oklahoma City, extending work of the Oklahoma Task Force to Eliminate Health Disparities for two more years have passed the Senate, but not without some sharp questions.
Senate Bill 1632 by Johnson and Rep. Opio Toure, D-Oklahoma City, passed 26-18, and SB 1636 by Johnson and Rep. Lisa Billy, R-Purcell, providing for a statewide integrated database, was approved 27-17.
"The nature of the questions shows the seriousness of the problem," Johnson said later.
Although the task force began its work in 2004, some senators were unaware of it and uncertain of the need. It is to submit a final report on its first two years in June.
A national poll by the Robert Wood Johnson Foundation released in December showed 68 percent of Americans unaware of disparities in health care, with only 25 percent of whites believing health care is worse for racial and ethnic minorities.
"It's amazing," said Carter McBride of Oklahoma City, chairman of the task force's Health Access committee who was appointed by Gov. Brad Henry. "You can go to a hospital or clinic and observe it. It's an ongoing issue."
A preliminary report from McBride's committee said, "lack of health access among minority and ethnic populations in Oklahoma is an epidemic." 
Surveys for more than 20 years have documented that ethnic and racial minorities receive a different level of care, a Harvard doctor said in the foundation report. Oklahoma surveys indicate similar results. Reasons include unequal access to services and research, institutionalized forms of discrimination and policies that result in an adverse impact. Patients told of feeling discrimination because of race, language, lack of insurance and ability to pay, weight, grooming and education, among other reasons.
McBride said the panel had been told that one reason Mexican immigrants use emergency rooms so heavily is that it's the customary thing to do in Mexico.
Much of the Senate floor questioning focused on the term "cultural competency," the subject of one of the panel's committees.
"What's that mean?" asked Sen. Randy Brogdon, R-Owasso.
"Even after your explanation, I still don't understand it," Sen. Brian Crain, R-Tulsa, told Johnson.
Johnson later provided several definitions from authorities, essentially boiling down to a health care provider's ability to slip into the patient's shoes. A U.S. Department of Health and Human Services report said various definitions require "the adjustment or recognition of one's own culture in order to understand the culture of a patient."
The definition used by the task force is "a set of congruent behaviors, attitudes and policies that come together in a system, agency or among professionals that enables effective work in cross cultural situations."
One of the recommendations proposed to the task force is for medical schools to include a class in cultural competency, which has met some resistance, McBride said.
As an example of a cultural competency problem, Johnson cited the case of an African-American member of the task force. He recently had a successful prostate cancer operation, but only after an older white physician decided to test him, knowing that black males are especially prone to it. A younger white doctor did not know that and had missed the diagnosis, she said.
The recent release of the State of the State's Health by the State Board of Health once again shows Oklahoma faring worse than most of the nation in key health statistics.

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A bill to provide a driver's license or identification card to convicts leaving prison failed, 21-23, in the Senate, possibly because another provision on faith-based reintegration programs included an amendment barring discrimination in employment.
Sen. Daisy Lawler, D-Comanche, served notice of reconsideration for her bill, which she proposed as a measure to reduce recidivism. Without an ID, she said, newly released offenders cannot cash a check and may be inclined to steal to survive.

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Having approved a ban on hand-held cell phones by kids driving with learner permits, the Senate may vote next week on a proposal to prohibit all drivers from talking and driving without a hands-free unit.
Sen. Clark Jolley, R-Edmond, author of the cell phone measure sent to the House, said drivers under 18 using a cell phone are four times as likely to have an accident.
Johnson failed in an attempt to amend it to include all drivers but has a bill of her own with that goal and hoped for a vote next week.
"Here we go again, picking on the kids," said Sen. Frank Shurden, D-Henryetta.
He said he would vote for a ban on all drivers using hand-held cell phones.
Sen. Cal Hobson, D-Lexington, successfully struck the title of Jolley's bill to allow further changes.

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