Nearly all of us remember suffering through multiple vaccinations as children, for everything from the measles and polio to those painful tetanus inoculations. But medical experts are warning that older adults, particularly African Americans and Latinos, are disproportionately at risk for preventable illnesses because they are not getting vaccines themselves.
“I’m urging all adults, especially African Americans over the age of 65, to think about prevention,” says former U.S. Surgeon General and chairwoman of the National Prevention Council Dr. Regina Benjamin. “We have the blue cards [that] kids have to have, but adults don’t have that, and we forget that we need vaccinations as well. We really don’t talk about it as much, and that’s why we need to raise awareness.”
Benjamin says that studies show that although black people are at increased risk for chronic diseases ranging from high blood pressure and diabetes to heart disease, African Americans have lower vaccination rates than other racial groups. She points in particular to pneumococcal pneumonia, the most common type of bacterial pneumonia.
“It affects the lungs and is caused by germs. It affects older adults in particular because they are at increased risk,” Benjamin explains. “Besides getting a vaccination, there are ways you can prevent pneumonia. Wash your hands, talk to your doctor and make sure you are protected.”
She’s been working with officials at Pfizer on a campaign to help increase the number of older Americans of color who are getting the vaccinations they need.
“I tell folks all the time, our skin sags at 55 and older, and sometimes the immune system sags as well,” says Pfizer’s chief medical officer, Dr. Freda Lewis-Hall. “It becomes a little less capable of protecting us from the onslaught of certain illnesses, so we become susceptible.”
Lewis-Hall and Benjamin will be addressing some of these issues at a breakfast panel discussion Friday morning at the National Association of Black Journalists and National Association of Hispanic Journalists joint convention and career fair in Washington, D.C.
According to the Centers for Disease Control and Prevention, about 900,000 adult Americans get pneumococcal pneumonia each year, and 5-7 percent die from it. And although 95 percent of those who die are adults, an estimated 67 million adults haven’t been vaccinated against it. Lewis-Hall says that among adults 65 and older, less than 50 percent of African Americans are inoculated against the disease, and less than 40 percent of Hispanics have been vaccinated.
“Pediatricians are really focused on seeing their patients are vaccinated. Doctors who treat adults, not so much,“ Lewis-Hall says. “We know there are physicians who often fail to recommend vaccinations in general for adults … and in too many cases, people don’t have a primary care doctor.”
Part of the problem is that many people of color distrust the medical establishment, partly because of the Tuskegee syphilis study, which ran for 40 years beginning in 1932, in which black men with the disease were left untreated. So in addition to adults not knowing that they need a particular vaccination, Lewis-Hall cites a number of studies showing that older African-American men in particular resist or neglect health care interactions because of that study.
“There’s been a whole host of confounding factors that keep us away from prevention opportunities,” Lewis-Hall says.
But the health disparities for people of color go far beyond older adults failing to get vaccines. In 2014 the D.C.-based health care consumer-advocate organization Families USA released numbers showing that African Americans, Latinos, American Indian and Alaska Natives, along with Asian Americans and Pacific Islanders, are far more likely to suffer from certain health conditions. They’re also more likely to have serious complications and die from them in comparison with non-Hispanic whites.
The organization also found that African Americans are 40 percent more likely to die from strokes, and Asian American and Pacific Islanders are 80 percent more likely to die from liver cancer. Blacks are also 30 percent more likely to die from heart disease, and Latinos are 45 percent more likely to die of diabetes. African Americans are 60 percent more likely to be diabetic and twice as likely to suffer an amputation of a leg, foot or toe because of the disease.
“The first issue is, can we prevent diabetes in the first place?” says Sinsi Hernández-Cancio, director of health equity at Families USA. “But once you get it, what can we do to help diabetics manage it better so they don’t end up with these terrible outcomes?”
Part of the problem, she notes, is that before the Affordable Care Act, people of color had less access to insurance than whites and were less likely to get treatments. Currently, black and white children have the same uninsured rate, but that doesn’t fix other pervasive issues. Hernández-Cancio says that some health care providers lack what she calls “cultural competence,” or an understanding of where their patients are coming from.
“Most of what produces your health, good or bad, has a lot more to do with social determinants,” Hernández-Cancio explains. “Which is where you live, where you work, where you play, where you pray, because all of those factors influence how much health risks you face and what your health assets are as a person and as a community.”
She tells the story of an African-American doctor in Philadelphia who kept writing asthma prescriptions for a child, but his symptoms weren’t improving because of triggers including low-grade housing, problems with air quality and vermin.
“The solution to these disparities has to happen all across the board, from where you live and go to school to your economic situation, risk of violence and ability to exercise,” Hernández-Cancio says, adding that the ability to afford healthy food, let alone having a nearby place to buy it, is also a factor.
So, she says, is racism.
“Even the most educated African-American women have worse birth outcomes than the least educated white women,” Hernández-Cancio says. “Nobody can show why that is, other than the fact that there are a lot of effects on your overall health when you have to deal with the toxic stress of racism every day. There’s been work done on adverse childhood events, showing that the more of those a person has, it not only leads to obvious mental-health issues as an adult but chronic physical conditions as an adult as well.”
Hernández-Cacio says that the only way to solve some of these problems is a comprehensive overhaul, finding ways to distribute resources fairly and putting together health care systems that can provide the highest-quality care to everybody.
Allison Keyes is an award-winning correspondent, host and author. She can be heard on CBS Radio News, among other outlets. Keyes, a former national desk reporter for NPR, has written extensively on race, culture, politics and the arts. Follow her on Twitter.