Article Summary

I had the privilege of growing up with three great-grandmothers.  One of these amazing women tended her own garden, was always on hand with home remedies, and relied on an occasional aspirin when she was well into her 80’s for extreme aches and pains.  One was quite a hypochondriac who insisted upon a daily regimen of medications that kept her well for any ailment.  I was always confident the doctor issued a fair number of placebos, such as sugar pills, just to satisfy her demands for medication. (This topic is important later.)  The third grandmother loved to go to the doctor.  I don’t believe she had ailments as much as she loved the attention.  His touch, his smile, his compliments kept her coming back on a regular basis.  There was nothing inappropriate here, but to acknowledge how older, widowed, potentially lonely people, seek trust and friendship.

My great-grandmothers were very close to the same age.  How could they be so different?  Think of your brothers and sisters or others close to you.  Do you all share the same viewpoint?  You come from the same family.  That is why I am challenged to analyze a group of people and say this is absolutely why the opioid epidemic is more prevalent in one group of people versus another.

First, let’s take a look at access.  Is it more consequential that before the ACA (Affordable Care Act), before 2014, fewer people who are black had insurance and access to prescribed opioid medication?

Here are the U.S. Census Bureau QuickFacts: United States

PEOPLE

Race and Hispanic Origin

White alone 76.3%

Black or African American alone 13.4%

American Indian and Alaska Native alone 1.3%

Asian alone 5.9%

Native Hawaiian and Other Pacific Islander alone  0.2%

Two or More Races 2.8%

Hispanic or Latino 18.5%

White alone, not Hispanic or Latino 60.1%

a = includes persons reporting only one race

b = Hispanics may be of any race, so also are included in applicable race categories

medication?

According to the National Low Income Housing Authority, here are some statistics that reveal the number of people on welfare assistance.  This does not mean, however that they are on Medicaid.  The striking numbers when we consider social determinants are that if there are 76.3% of people who are white in America and 13.4% of people who are black in America, why aren’t 76.3% of welfare recipients white and 13.4% black, or close to it?  (See the chart below.)

What are we doing to address poverty, or those in need of assistance?  Nearly 40% of Americans who receive welfare assistance are black, where proportionately, this group of people should be less than one half of that.

Finally, The Truth About Welfare — How Many Blacks Vs. How Many Whites (lowincome.org)

Number of Americans receiving welfare assistance: 110,489,000
Number of Americans receiving food stamps: 41,700,000
Number of Americans on unemployment insurance: 10,200,000
Percentage of the US population on welfare: 35.4%
Total government spending on welfare annually: $131.9 billion

So how many Blacks vs whites?

Well, believe it or not, the numbers are actually about the same. There are just about as many whites on welfare as there are Blacks.

Percent of welfare recipients who are white: 38.8%
Percent of welfare recipients who are black: 39.8%

(NoteMany people confuse these statistics. This does not mean that 38.8% of all white Americans, and 39.8% of all Black Americans are on welfare. It means that 39.8% of all the actual welfare recipients are Black, and 38.8% of all the welfare recipients are white.)

And contrary to popular belief, a lot less immigrants are on welfare.

Percent of welfare recipients who are Hispanic: 15.7%
Percent of welfare recipients who are Asian: 2.4%
Percent of welfare recipients who are Other: 3.3%

(NoteAgain, this does not mean that 15.7% of all Hispanic Americans and 2.4% of all Asian Americans are on welfare. It is referring to the percentage of welfare recipients)

While we should be excited that more Americans have access to healthcare, it also means that more Americans have access to prescribed opioids.  See chart below.

Effect of the Affordable Care Act on Racial and Ethnic Disparities in Health Insurance Coverage (nih.gov)

In 2013, 40.5% of Hispanics and 25.8% of Blacks were uninsured, compared with 14.8% of Whites. We found a larger gap in private insurance, which was partially offset by higher rates of public coverage among Blacks and Hispanics. After the main ACA provisions went into effect in 2014, coverage disparities declined slightly as the percentage of adults who were uninsured decreased by 7.1 percentage points for Hispanics, 5.1 percentage points for Blacks, and 3 percentage points for Whites. Coverage gains were greater in states that expanded Medicaid programs.

If fewer people who are black are prescribed opioids is it because they aren’t asking or demanding these drugs?  Let’s consider why doctors are prescribing opioids to known opioid abusers.  How do you shop for a doctor?  How do you pick a restaurant, hotel, or product?  Do you read the reviews?  If there are 99 five-star reviews and 1 one-star review, do you read the one-star first?  Can doctors afford a bad review?

Do people who are black have equal access to doctors?

If my great-grandmother didn’t get her sugar pill, would she have bad-mouthed this doctor publicly?  Doctors cannot afford a bad review.  So, do they consequently give their patients what they want or demand?  I believe this answer is yes.  If you have not had access to a doctor, do you know what to ask?  Do you know you can ask, or are you expecting the doctor to tell you what you need?

26 Mind-Boggling Online Review Statistics & Facts for 2021 (websitebuilder.org)

When we reach equality of services among each culture, we should reach equality of results.  Or, as this the opioid epidemic demonstrates, equal results of its consequences.