Bmj Usa Editorial

Left behind

BMJ 2005; 331 doi: (Published 13 October 2005) Cite this as: BMJ 2005;331:E384
  1. David Atkins, chief medical officer (,
  2. Ernest M Moy, senior service fellow
  1. Center for Outcomes and Evidence
  2. Center for Quality Improvement and Patient Safety Agency for Healthcare Research and Quality Rockville, Maryland

    The US hurricane puts the health effects of poverty and race in plain view

    Thomas LaVeist, a Baltimore expert in health disparities, has used the sinking of the Titanic to illustrate the effects of income and class on health, noting that women in first-class cabins were much more likely to survive than those booked in lower classes. In the aftermath of Hurricane Katrina, Americans have been shocked and shamed to realize we still don't have enough lifeboats for all our citizens. Live images of uncollected corpses and families clinging to rooftops made vivid what decades of statistics could not: that being poor in America, and especially being poor and black in a poor Southern state, is still hazardous to your health.

    This may truly be a “teachable moment” about the impact of poverty and race on health. The gap in health care for white and black Americans alone has been estimated to cause 84 000 excess deaths a year in the US, a virtual Katrina every week.1 Because the victims gradually succumb to various diseases such as diabetes, cardiovascular disease, alcohol and drug abuse, cancer, and HIV infection, they rarely capture …

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