[Congressional Record Volume 150, Number 57 (Thursday, April 29, 2004)]
[Senate]
[Pages S4673-S4674]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                NATIONAL MINORITY CANCER AWARENESS WEEK

  Mr. DASCHLE. Mr. President, last week was National Minority Cancer 
Awareness Week, an annual event for the past 18 years. Though we have 
been monitoring disparities in cancer for nearly two decades, the gap 
in some cancer mortalities has widened rather than narrowed.
  One of the most important reasons for this disparity is poor access 
to health care. People who do not get mammograms, colon exams, and Pap 
tests on schedule are more likely to be diagnosed with cancer at a 
later stage of the disease, when survival rates are lower. And why 
don't they get these necessary tests on time? Members of racial and 
ethnic minority groups are more likely to be poor, have lower education 
levels, and less likely to have health coverage or a source of primary 
care.
  Recently, I told the story of a young Indian girl who was 
misdiagnosed with heartburn at an under-funded Indian Health Service 
clinic. It turned out that she really had stomach cancer that had 
already spread and was, therefore, untreatable. I will remind you that 
this is not some rare exception. For Native Americans and other 
minority communities across the country, the miracles of modern 
medicine--and sometimes even the most basic primary care--are beyond 
their reach.
  The disparities within our health care system have reached a crisis 
point, and the consequences for America's minority communities are 
staggering.
  Overall, African Americans are more likely to develop cancer than 
persons of any other racial or ethnic group.
  Cervical cancer incidence in Hispanic women has been consistently 
higher at all ages than for other women.
  Only 52 percent of American Indian/Alaska Native women aged 40 years 
and older have had a recent mammogram.
  American Indians and Alaska Natives have the poorest survival rate 
from all cancers combined when compared to other racial and ethnic 
groups.
  I am grateful that National Minority Cancer Awareness Week causes us 
to reflect on these facts. America faces few more important or complex 
challenges than building a world-class health care system for everyone, 
regardless of race, income, or geography.
  There are no quick fixes. The factors that have led to these 
inequities in our health system are complex and interrelated.
  Minorities are far less likely to have health insurance or a family 
doctor, making regular preventive visits less likely. And many of those 
who do have insurance report having little or no choice in where they 
seek care.
  Minority communities are more frequently exposed to environmental 
risks, such as polluted industrial areas, cheap older housing with lead 
paint, or asbestos-laden water pipes.
  For Hispanics, Native Americans, and others who do not speak English 
as a first language, the lack of translators and bilingual doctors 
makes it more difficult to communicate with doctors and nurses.
  The Native American community has been forced to cope with a system 
suffering from decades of neglect and underfunding of the Indian Health 
Service. The IHS has consistently grown at a far slower rate than the 
rest of the HHS budget, and at only a fraction of health care 
inflation.
  America is obligated, by statute and by treaty, to provide health 
care for American Indians--a commitment the U.S. Government made to the 
Indian people in exchange for their lands. America is not honoring that 
commitment. The White House's budget this year included only $2.1 
billion for IHS clinical services. That is more than 60 percent below 
the bare minimum needed to provide basic health care for people already 
in the IHS system.
  The problems run still deeper. Even when minorities and white 
Americans have roughly the same insurance coverage, the same income, 
the same age and the same health conditions, minorities receive less 
aggressive and less effective care than whites.
  The racial and ethnic disparities in our health care system are not 
merely minority issues or health care issues. They are moral issues. A 
health care system that provides lesser treatment for minorities 
offends every American principle of justice and equality.
  The Republican Leadership has promised to address these issues.
  After seeing no action for almost a year, House and Senate Democrats, 
led by the House Minority Caucuses, introduced the Healthcare Equality 
and Accountability Act of 2003.
  This legislation would reduce health disparities and improve the 
quality of care for racial and ethnic minorities. There are several 
elements of this bill that would specifically address minority cancer 
rate reduction. I would like to highlight four particularly important 
issues.
  First, this bill will provide adequate funding for the Indian Health 
Service--so that we can finally stop the shameful underfunding of 
Indian health needs.
  Second, it will provide funds to increase cancer prevention and 
treatment programs. This includes the development of screening 
guidelines for minority populations for chronic diseases, including 
prostate, breast, and colon cancer.
  Third, this bill will provide funding through the Health Research and 
Services Administration, the Indian Health Service, and the National 
Cancer Institute for patient navigators. Patient navigators work in 
underserved communities to bring individuals into the health care 
system sooner, so they can learn about preventing and detecting 
diseases--especially cancer--before they become ill. Patient navigators 
also help individuals overcome language and cultural barriers to 
setting up appointments and understanding their doctors' instructions. 
Patient navigators can also be important resources to individuals 
living in rural areas, since they often have to travel outside their 
communities to receive certain health services. The American Cancer 
Society notes that ``Patient navigator programs offer a low-cost, 
tangible fix in a part of our health care system that is broken, giving 
hope to millions of medically underserved individuals, saving lives and 
reducing health care costs.''
  The last item I would like to highlight in this bill is the focus on 
improved health literacy, the degree to which individuals can obtain, 
process, and understand basic health information. The bill will provide 
funds to support programs that remove language and cultural barriers. 
Just two weeks ago, the Institute of Medicine released its report on 
health literacy and recommended that ``Government and private funders 
should support the development and use of culturally appropriate new 
measures of health literacy.''

[[Page S4674]]

  On that same day, the Agency for Healthcare Research and Quality 
released findings that showed that individuals with low literacy--
lower-than-average reading skills--are less likely than other Americans 
to get potentially life-savings screening tests such as mammograms and 
Pap smears.
  In addition, Secretary Thompson remarked that, ``We must ensure that 
all Americans get the prevention and health information that they can 
understand and use to keep themselves and their families healthy.'' He 
pointed out, ``Health literacy can save lives, money, and improve the 
health of millions of Americans.''
  The Healthcare Equality and Accountability Act would move us closer 
to the goal of ensuring equal access to quality health care.
  Last year, the majority leader said, ``Inequity is a cancer than can 
no longer be allowed to fester in health care.''
  I agree. We know what happens when cancer is allowed to spread.
  Too many Americans in minority communities have lost their lives 
because they are not getting the care they need. We cannot afford to 
wait any longer to confront the minority health gap in our country.
  Americans are asking for our leadership on a challenge that is 
quickly becoming a national emergency. We have an obligation to answer 
their call.

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