[Congressional Record (Bound Edition), Volume 162 (2016), Part 6]
[Extensions of Remarks]
[Page 8629]
[From the U.S. Government Publishing Office, www.gpo.gov]




NEED TO ELIMINATE HEALTH DISPARITIES IN RURAL AND UNDERSERVED MINORITY 
                              COMMUNITIES

                                 ______
                                 

                          HON. TERRI A. SEWELL

                               of alabama

                    in the house of representatives

                         Monday, June 13, 2016

  Ms. SEWELL of Alabama. Mr. Speaker, in light of the myriad of issues 
facing Americans living in poverty, I am disappointed that my 
Republican colleagues chose a drug treatment center as the location to 
unveil their anti-poverty proposal last week. Assuming the poor are 
more prone to impulsivity and addiction ignores the reality that 
poverty is often the result of a constellation of compounding 
difficulties that are exacerbated by poor access to healthcare and our 
nation's historic dis-investment in public health. Today, I am here to 
highlight the impact these complications have on my most vulnerable 
constituents and the role we all play in addressing them.
  The harsh disparities faced by my constituents in Alabama's Black 
Belt intersect at the nexus of poverty, demographics, and geographic 
access.
  Women in certain parts of my district have to drive to distant 
counties, sometimes two hours, to give birth to their babies. Folks in 
Choctaw County, Alabama have to travel over 100 miles to the closest 
full-service urban hospital or to see a specialist. In 6 of the 14 
counties I represent, there are fewer than 5 primary care physicians, 
county-wide.
  The prostate cancer death rate in Alabama for black men was triple 
that of white men from 2000 to 2010. For all cancers, the mortality 
rate among blacks was more than double that of the white population 
during the same time period.
  There are many settings that would have better told the story of 
struggling Americans than an addiction treatment center. An emergency 
room in a rural hospital in my district would have been a great place 
to start.
  In this setting, the group would meet the working Alabamians who fall 
into our state's Medicaid gap. With the lowest Medicaid eligibility cap 
in the country, the working poor are left with no option for affordable 
health coverage.
  Because of financial constraints, these individuals ignore small 
health care concerns until they compound to make for an emergency 
situation, which can only be addressed in the expensive setting of an 
emergency room. There are many who leave the emergency room less able 
to work and provide for their families because of the long-term impact 
of allowing untreated health issues to compound.
  In addition to severe access issues, generations of men and women in 
Alabama's 7th District have been negatively impacted by the tortured 
legacy of the Tuskegee Syphilis Study. While I applaud decisions to 
provide medical benefits to the family members infected, and the 
apology issued by President Clinton in 1997, these actions only began 
to address the damage this 40 year experiment had on our most 
vulnerable communities.
  There are decades of research that show that minorities often do not 
seek treatment for conditions because of distrust of health care 
providers regarding diagnosis, prognosis, and treatment. The mistrust 
the Tuskegee study generated interferes with attempts to combat HIV/
AIDS, sickle cell anemia, uterine fibroids, prostate cancer and a 
myriad of other conditions that disproportionately impact minority 
groups.
  If we are serious about addressing health disparities in rural and 
underserved communities, we must start by working to restore the faith 
all of our constituents have in the medical establishment, particularly 
public health programs, vaccinations, and clinical trials. We should 
view this as an issue needing as much intervention as drug abuse and 
inner-city violence.
  I was sent to Congress by one of the most underserved constituencies 
in the country to build upon programs that work and craft new proposals 
to reverse this cursed course. I look forward to working with my 
colleagues to strengthen the Medicare and Medicaid programs, invest in 
health education and medical research, and incentivize providers to 
practice in rural and underserved communities.

                          ____________________