The last week of February 2008 marked the first anniversary of the death of Deamonte Driver, the twelve-year-old-boy from Prince Georges’ County, Maryland who died from a tooth infection that spread to his brain. His death was another sorry statistic in the litany of sorry statistics about the disparities in health and access to health insurance for members of minority communities and more generally poor and disadvantaged Americans.

In recent weeks readers of the Washington Post have learned that dental disparities not only affect the young and poor, but also afflict the poor elderly, as Medicare does not cover oral health. The New York Times, on the other hand, has informed us of the latest trend in middle-class vacations: the dental vacation featuring dental practices and resorts in Asia, Latin America, and Hungary.

Basic dental coverage to maintain good oral health has been left out of most of the discussions about health care and insurance. Readers of the upcoming Health Affairs theme issue on disparities–to be posted next Tuesday, March 11, online–will find an overview of how dental neglect contributes to poor overall health and disparities across all age groups and ethnic/racial communities in the United States.

The lack of access and affordability of dental care is only one aspect of the enduring chasm of racial and ethnic disparities in health–in health access, health status, and health outcomes–that have marked the history of U.S. health care. From the time that we have records, dating back to the Civil War, black soldiers were almost four times more likely than white soldiers to die of disease while serving in the army.

Dying early and often from disease was not only a feature of nineteenth-century life. Persistent disparities between the races continue to affect the life span today from infanthood through adulthood. David Satcher and colleagues reported finding 83,000 excess deaths per year in the African American community, many coming from cardiovascular disease and cancer, in an earlier Health Affairs theme issue on disparities.

The role of race and its relationship to social determinants of health are examined in the upcoming March/April 2008 Health Affairs issue on disparities. In a year where many people are focused on reforming the U.S. health care system, it is worth remembering that we won’t truly get reform for all Americans if we do not address the current disparities that permeate the system.

This entry was posted on Tuesday, March 4th, 2008 at 5:59 pm and is filed under Access, All Categories, Disparities, Nonmedical Determinants, Public Health. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.