The issue of health care disparities between socioeconomic and
racial groups was given a new spin with the release of a new study
drawing a link between HIV patients’ accumulated wealth and
how soon they will succumb to the virus.
The study, led by Dr. William Cunningham, a professor of
medicine and public health at UCLA, found that HIV patients with a
low socioeconomic status are more likely to die sooner than
patients who have more wealth and education. HIV is the virus that
causes AIDS.
Results were based on a study of 2,864 adults receiving HIV care
and accounted for the factors of net accumulated assets, annual
income, education level, employment status, race or ethnicity,
medical insurance, and the use of medications and services at the
beginning of the study.
The results of the study were published in the November issue of
the Journal of Health Care for the Poor and Underserved. What
separates this research from similar studies that link income and
HIV survival is the focus on assets in addition to income,
Cunningham said.
“It’s much more likely that those who have some
savings or who are lacking debt are more in a position to use
available funds to get services,” he said.
Access to certain services and the ability to afford them factor
largely into how a patient fares with the virus, Cunningham
said.
“The optimal pattern of services consists of patients
regularly seeing their physician and getting a set of monitoring
services as well as treatments,” he said.
Blacks and Latinos are the racial groups in the United States
with the highest rate of HIV infection, but the least likely to get
ideal care. Instead they tend to rely on emergency room and
ambulatory services, Cunningham said.
“People that go to the emergency room without being
hospitalized are less likely to have consistent monitoring and
appropriate therapy provided to them,” he said.
Cunningham noted the increased likelihood of lower socioeconomic
groups to engage in high risk behaviors ““ such as having
multiple sexual partners, sharing needles when using drugs, and
using drugs or alcohol while engaging in sexual behavior ““ as
a factor the high rate of HIV infection in these groups.
The behavioral changes that come with taking drugs tend to
interrupt the cycle of taking HIV medications, said Dr. Obi Umeh, a
clinical instructor at the UCLA Center for Clinical AIDS Research
and Education.
Umeh said inconsistency in taking HIV medications reduces their
effectiveness.
He said another reason many people in lower socioeconomic groups
don’t live as long as wealthier patients is that they often
wait to come in for treatment until the virus has progressed
because they are either unable to pay for services or lack health
insurance.
“There’s a relationship between how early you start
a treatment and how well you recover,” he said.
Umeh also said wealthier patients are more likely to come in to
see their doctors if HIV medications are causing unwanted side
effects, whereas lower socioeconomic group patients who are less
educated about the effects of medications may just stop taking the
medicine.
Dr. Toni Yancey, associate professor of health services and
co-director of the Center to Eliminate Health Disparities in the
UCLA School of Public Health, said many other things negatively
affect the general health of lower socioeconomic groups.
Yancey said the proliferation of fast food chains, the absence
of fresh produce markets, and the lack of safe venues for physical
activities, like parks and recreational centers, in poorer
neighborhoods contribute to the unhealthiness of these
communities.
She said the concentration of low income people in certain areas
drives away business that would help community members get food at
lower prices and provide more jobs.