The contentious debate over heath care has huge implications for African Americans. The Senate health committee this month is tackling the issue in response to President Barack Obama’s proposals. The aim is better care at more reasonable rates, especially for the 46 million citizens who are uninsured.

Blacks in general stand to benefit. The National Institutes of Health reported in March that “As many as 1 in 100 black men and women develop heart failure before the age of 50, 20 times the rate of whites in this age group.” Its study showed that “heart failure developed in black participants at an average age of 39, often preceded by risk factors such as high blood pressure.”

“Black women have almost twice the rate of advanced breast cancer as white women do, largely because the disease is often diagnosed after it has already progressed,” according to a May report from the Division of Oncology at the Emory University School of Medicine. The report also said some black women in the study refused radiation treatment and chemotherapy treatment. Social and cultural reasons were given as factors. Poverty also was an issue because some low-income women “don’t have the job security that some other people have. If they are absent from their job for days in a row, they’re going to lose their job.” Dr. Gretchen Kimmick, an associate professor of oncology at Duke University Medical Center, said, “Some of the women we take care of think God is going to take care of them, so they don’t pursue their treatment.” Some women were said to be embarrassed because they could not afford treatment.

The problem also touches children. The Office of Minority Health states that African-American infants’ deaths occur at a rate of 14.1 percent, double that of whites.

Senator Tom Harkin (D-Iowa), who heads the group drafting the Prevention and Public Health section of the bill before Congress, said: “We currently do not have a health care system in the United States; we have a sick care system. If you’re, sick, you get care, whether through insurance, Medicare, Medicaid, SCHIP, community health centers, emergency rooms, or charity. The problem is that this is all about patching things up after people develop serious illnesses and chronic conditions.”

Obama’s recent speech to the American Medical Association (AMA) has been called “the most comprehensive statement about reform he has ever made publicly.” He talked about the fear of change and said, “If we do not fix our health care system, America may go the way of GM; paying more, getting less, and going broke.”

The AMA has opposed publicly sponsored health insurance since 1918. Fears that the government will interfere with the patient-doctor relationship as well as financial concerns have driven the AMA’s opposition.

Harkin said, “We spend a staggering $2.3 trillion annually on health care – 16.5 percent of our GDP and far more than any other country spends on health care – yet the World Health Organization ranks U.S. health care only 37th among nations, on par with Serbia. We spend twice as much per capita on health care, but we are twice as sick with chronic disease…. Some 75 percent of health care costs are accounted for by heart disease diabetes, prostate cancer, breast cancer, and obesity.” He indicated these diseases and conditions are largely preventable and even reversible with changes in nutrition, physical activity and lifestyle.

Regarding the health of blacks, account must be taken of living conditions on top of the racism that has prevailed. This has been discussed by scholars such as Clovis E. Semmes who said, “Blacks are over represented in ‘high-risk’ occupations, which frequently expose them to toxic chemicals, and African-American communities are more likely than other communities to be located near dumping grounds for municipal refuse and toxic waste.”

Besides new health care policies, recommended changes for all citizens include: increasing physical activity, reducing excess weight and obesity, eliminating tobacco use, eliminating substance abuse, engaging in responsible sexual behavior, reducing injury and violence, and seeking health care early.

Prevention programs are being proposed for workplaces, communities and schools. But in order for such programs to help citizens will have to adjust their behavior. The changing of habits has never been easy. But times of crisis sometimes induce people into taking actions they otherwise might have resisted. An investment in good health practices will pay big dividends.

(George E. Hardin worked as a photographer, reporter and editor, and in public relations during a long career before he retired. His column appears every other week.)