The numbers aremind-boggling. Black Americans have higher disease and death rates and theshortest survival of any racial and ethnic group in the United States for mostcancers and other debilitating and chronic conditions. What fuels these healthdisparities is a complex mix of factors, but some of the main culprits includea lack of routine care and prevention, reduced access to care and fewertreatment options.

The African-American community’sunequal burden of poor health disparities is linked to race, socioeconomicstatus and geographic location, suggests Representative Joe Armstrong (D–Knoxville),who chairs the Tennessee Black Caucus of State Legislators. He points out that socialinjustice and cultural conditioning also add to the problem.

Armstrong is a health careadvocate who believes that improving the economic wellness of the blackcommunity will in turn boost the community’s physical health and lower itscancer death rates. In fact, Armstrong says, the National Black Caucus of StateLegislators’ (NBCSL), the parent organization each state’s black caucus of statelegislators belongs to, evaluates state policies that affect ethnic communities,looking for ways to boost their economic standing.

But some researchers disagreewith Armstrong’s viewpoint. These scientists point to studies that show AfricanAmericans’ lower cancer survival rate may not be totally caused by social and economicfactors such as work, wealth, income, education, racial discrimination, housingand standard of living inequalities, and lack of health care access.

One study, published in a 2009edition of the Journal of the National Cancer Institute, suggested blacks had a poor survival outcome forcertain cancers largely based on biological differences.

The study showed that tumorbiology, inherited gene variations and interactions among the body’s hormonesmight play a significant role in the survival gap experienced by black breast,prostate and ovarian cancer patients.

What’s more, culturalconditioning also plays a role in African Americans’ higher cancer deathincidences, Armstrong says. Take for example the case of Touraine Lynch, aformer military sergeant who was diagnosed with cancer in 2002.

While in the U.S. Army, Lynchbegan to experience chronic fatigue, loss of appetite, localized skin darkening,brittle hair and nails and a lump she assumed was from her extensive trainingfor a 10-mile road march. At the time, Lynch was preparing for a membershipexam for the Audie Murphy Club, an elite noncommissioned officers organizationwithin the Army.

“I had no idea what was goingon with me. It was the most bizarre thing ever. I felt in my mind that itcouldn’t be anything serious because I was a solider in the Army, physicallyfit and loved the outdoor life,” Lynch says.

Lynch didn’t know what wascausing her symptoms. Then she began experiencing night sweats. When Lynchasked her platoon sergeant for clearance to visit the military clinic, she wasdenied permission. “I endured the night sweats for at least a week before Isought medical attention,” she says.

Lynch hesitated to listen toher body and seek medical assistance (even before her night sweats episode). Sheignored her symptoms because she thought she couldn’t possibly be sick. “It wasthe most bizarre thing,” Lynch says. “In my mind, I felt it couldn’t beanything serious.”

And that, Armstrong says, is anexample of cultural conditioning that results in African Americans of both gendersnot getting diagnosed until too late.

Too many people believe thatadmitting to having an illness means you are weak. “We need to get rid of thesemyths and these things that keep us from going and getting checked—that’sleading to high death rates in the African-American community,” Armstrong says.

“We need to develop a cultureof prevention,” he stresses. “When I speak to black men, I tell them, ‘Don’twait until your car starts smoking before you change your oil?’ Your body isthe same way. You’ve got to know what is going on with your body. You’ve got toget your glucose checked, get your blood pressure checked, and [have] thoseroutine screenings [in] order for you to be here and live a long and productivelife.”

Today, Lynch is in remission (since 2003) afterundergoing chemotherapy treatment for non-Hodgkin’s lymphoma, a cancer of the body’sdisease-fighting lymphatic system. But had her Stage 3 cancer been diagnosedmuch earlier (Lynch was given six months to live), she might have had a lessarduous treatment experience.

When Lynch’s cancer becameresistant to the chemotherapy, doctors put her on steroids to help shrink thecancer. But nothing seemed to work. Her last hope was a stem cell transplant.

Doctors cultivated and storedLynch’s stem cells then hit her with high-dose chemotherapy that knocked downher immune system to 99 percent. “That meant I could get sick from almostanything,” she says. But the chemo destroyed the cancerous cells, and doctorsreplaced them with the cancer-free stem cells they’d previously harvested fromLynch’s body. (This process is called an autologous transplant.)

But unlike Lynch, manyother African Americans experience far greaterbarriers to care, in particular the ones previously mentioned atthe beginning of this article. These barriers stop people from getting a cancerdiagnosis along with the care and treatment needed for improved outcomes.

To improve this situation, Armstrongsays, we need lawmakers and legislation to address existing health disparitiesin each state’s underserved black communities.

What’s more, African Americansmust also have access to care so they can get to a nearby clinic or doctor, Armstrongsuggests. Why? Because having access to medical care would lead to earliercancer diagnoses and treatment.

In general, Armstrong adds, thecommunity as a whole also needs to focus on cancer prevention with lifestylechanges, such as transforming diets high in fat, sugar and salt into well-balancedeating regimens that promote cancer prevention and overall better health andwellness.

Finally, it’s also importantthat black communities become a more vocal minority to spark legislativechanges. “What we need to do is make sure that we participate and that we vote,”Armstrong advises. “A lot of people don’t realize the influence that governmentand political policies have on people’s lives when it comes to health care.”