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Statistics show that African American men are at greater risk of dying from prostate cancer than white men and the majority of statisticians are in agreement that the risk in the case of African Americans is around about two and a half times that of white men. But, are these figures misleading? The answer might come from a study conducted not long ago in North Carolina. The study looked at a group of 253 white men and 84 black men between the ages of 40 and 75 who had been diagnosed with prostate cancer between 2001 and 2004. The study looked at several factors including, income, attitudes towards health care and health care providers, the existence of other medical conditions, treatment, family history, screening history, employment, access to care, symptoms and whether the men had health insurance. The study discovered that 55 percent of the black men earned less than $40,000 annually in comparison to to 23 percent in the case of the white men. The study also found that black men were more likely to be educated to a lower standard, to have a blue-collar job, to have co-existing medical problems and to be unemployed through disability or illness. Additionally, the study found that only 3 percent of white men had no medical insurance at all, in comparison to 8 percent of black men and that just over 30 percent of white men has some form of supplemental Medicare coverage, in comparison to 17 percent of black men. One particularly interesting finding was that both groups of men were equally well informed about both the risks of prostrate cancer and the requirement for treatment, but that the black men accepted greater responsibility for their own health and were not as likely to trust their doctors. Indeed a number of the black men stated they were wary of their doctors and felt that the advice they were giving was more likely to be based on the cost of treatment than it was to be based upon patient needs. On the important question of screening, black men were less likely to have regular check-ups, digital rectal examinations or prostate specific antigen (PSA) tests. The study also reported that black men were far more likely to have had to ask for a PSA test than white men. The study makes it clear that there is a marked different between the two groups that lies in the lack of early detection in black men and that this arises to a significant degree from the fact that they do not have well established relationships with their doctors, have poor access to convenient and affordable care and do not have adequate health insurance. Obviously it is difficult to assign numbers to a study of this type and further, and larger, studies will have to be conducted to quantify the differenced between African Americans and white men. Nonetheless, it would seem that much of the difference does not stem from the fact that African Americans are more likely to develop prostate cancer but stems from the fact that they are more likely to die from the disease because of its was detected late. If the gap between African Americans and white men as far as the provision of healthcare were closed the statistics could well look very different.
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