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Monday, May 15, 2000

Health care
inequity called
growing problem

Forty million in the U.S. lack
access to treatment, Hawaii
workers are told

By Helen Altonn


About 40 million people in the United States have no access to health care and the number is increasing, according to the American Public Health Association's president-elect.

"That is a major issue this country has not come to grips with yet," Michael Bird emphasized in a talk to the Hawaii Public Health Association.

Ira Pollack, regional manager of the Office for Civil Rights, U.S. Department of Health and Human Services, also said "health disparity is a hot issue." Providing services to people with limited English proficiency is a particular problem, said the San Francisco-based civil rights official.

His office enforces laws prohibiting discrimination in federally funded social and medical services to recipients in Arizona, California, Hawaii and Nevada. Pollack said complaints have been going up -- now totaling about 400 a year -- because of increased education and outreach.

"Eliminating Health Disparities: Promoting Health Equity" was the theme of the Hawaii Public Health Association's annual meeting Friday at Tokai University. Also speaking was Dr. Claire Hughes of the State Health Department's Office of Health Parity.

Bird, a Santo Domingo and San Juan Pueblo Indian of Albuquerque, N.M., also gave commencement addresses yesterday at the University of Hawaii.

He attended the UH School of Public Health in the last year of a master's program at University of California-Berkeley and has assisted Papa Ola Lokahi and the Native Hawaiian Health Care Systems.

Bird said he is focusing efforts on eliminating disparities and inequality relative to health care of major ethnic populations.

Health problems of those groups, including native Hawaiians, must be viewed in a historical and political context, he said.

Bird said it "may seem sort of trite" but he believes working together is the only way the issues can be resolved. "There are so many personal and political agendas," he said, explaining his goal is "to get people to agree to commit, to have a broader vision, work in unison and move together to address issues."

A plan of action will be developed and unveiled at an APH meeting in November in Boston, Bird said. He will take office at the meeting -- the first American Indian to head the organization in 128 years.

A lot of the work in Pollack's civil rights office relates to goals of the public health organizations to provide equal access to health care. He said the office enforces federal requirements in five priority areas.

One, resulting from a Supreme Court decision this year, involves the right of disabled people to get services in community or integrated settings rather than institutions.

Others are immigrant access to services, health disparities resulting from a shift to managed care plans, welfare-to-work issues and child welfare. Pollack said his office has had some complaints from Hawaii in child welfare and welfare-to-work areas.

With government efforts to move abused and neglected children into foster care or adoptions faster, he said, "Parents feel discriminated against on the basis of age or disability.... But a child's welfare is uppermost."

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