Health Disparities and the Culture of Lack – by William Hicks

Health disparities, i.e., differences in outcomes from disease experiences, are well-described and documented. The statistics that tell us of the incidence and prevalence of diseases within our populations (epidemiology) are readily available. In large measure, the prevalence (the number of cases within a population at any given time of measurement) of heart disease/high blood pressure, cerebrovascular diseases, diabetes, cancer, infectious diseases (influenza, pneumonia) are all among the top ten causes of death for all population subgroups (source:

The incidence (the number of new cases recorded within a population in a period of time) of these diseases varies, though not widely, due to a number of factors associated with the population’s socio-demographic characteristics. These include age, sex, ethnicity, economic wherewithal, location, environmental risk factors and behavior. For example, among African Americans, the seventh leading cause of death is assault (homicide), whereas suicide is the ninth leading cause of death among White Americans (source:, regardless of the population’s socio-demographics, in this culture, most deaths are recorded pursuant to those diagnoses cited above.

What, then, may be the cause of the observed disparities in the health status among population subgroups that account for differences in mortality and morbidity rates? A significant factor, in my observation, is differences in access to health care posed by economic barriers. In the recent past, health insurance was tied to an individual’s employment or to her poverty. If you had a job, one of the benefits of employment was some form of insurance that enabled access to medical care. If you were old and/or poor, federal and state-sponsored insurance- Medicare and Medicaid- afforded some measure of access.

But what happens if access to care by way of employment ceases? What happens if a state tightens its eligibility requirements for Medicaid? What happens if the insurance benefits profile offered by your employer is pared back due to negative changes in the employer’s bottom line? Why is it that most people struggle to afford the drugs prescribed by their providers? Why does the Medicare program have a “donut hole” in it, requiring the eligible elderly to “spend their way out” of the “donut hole” before the prescriptions become financially accessible to them, most of whom are on fixed incomes? Why does Medicare cover only 80% of Part A physicians’ services costs? Why is there an entire industry associated with the treatment of cancer and billions spent on research yet there is no cure for it?

In America, we live in a culture of lack which values disparities, especially economic and income disparities. All other manifestations of disparities- health disparities, so-called racial disparities, social disparities, education opportunity disparities- are, in large measure, a product of economic disparities. Capitalism, Marxism, communism, fascism, are all forms of managing the distribution of the common wealth of the people- the land, its resources, its systems for creating and enabling access to the necessities of life. When those charged with the stewardship of the common wealth focus more on personal inurement at the expense of the welfare and well-being of the people, disparities are created and perpetuated, creating a culture of lack. It creates a culture wherein one can say this: “If I can make a billion dollars, why can’t I keep it?” To which I respond, “When you have it all, possession becomes irrelevant, meaningless. Giving then becomes your priority.”

This planet was designed to replenish itself and its resources, so there should be no lack of the necessities for life, even an abundant life. Do we have the will to make it happen?

This article is background for the ADR October Black-Jewish Dialogue. CLICK for more information and to hear recording

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