Published: Tuesday, February 28, 2012 at 3:15 a.m. last Modified: Monday, February 27, 2012 at 3:34 p.m.

African-American babies die more often than white babies. Black people in South Carolina have higher rates of HIV/AIDS, prostate cancer and diabetes than white people.

The list could go on.

As Americans celebrate black history and the civil rights movement during this month, equity in health remains largely a concept rather than a reality in South Carolina, including Spartanburg.

So, why is one race healthier than another? And how does the community provide equitable health care for all of its members?

“If there’s a single reason, we would just target that and fix this,” said Matt Petrofes, director of the local branch of the state Department of Health and Environmental Control. “It’s just an overwhelming group of circumstances that put us in the way we are.”

Experts explain health inequities with a combination of factors: income, education, employment, transportation, environment, housing, access to health care services, racism and culture.

Dawn DeLisa, outreach coordinator at the Gibbs Cancer Center at Spartanburg Regional, encounters these inequities every day. It’s her job to erase them.

She often starts with education.

“Education is power, and once people know, it moves them to action,” she said.

In theory at least, knowledge translates into action. but there’s plenty of friction that keeps people from doing what they know is healthy.

While some people may be irresponsible, many others lack the health insurance, money and access to transportation that make it easier to address health concerns.

A woman working at Wal-Mart can’t leave for a few hours to see the doctor during normal business hours, and an insufficient bus system prevents many people from easily seeing a physician, said George Newby, CEO at ReGenesis healthcare, which provides health services on a sliding scale based on a patient’s income.

“Those are the kind of strategic issues that we’re going to be wrestling with to make good affordable primary care available to people,” he said.

Beyond education and barriers, health professionals also wrangle with history, culture and language.

“If you look back to under slavery, slave women typically would have to work almost up until the point of delivering, and they might have a little bit of time off, and then they would have to go back,” said Carmen Harris, a professor of history at USC Upstate, during an interview at an African-American history symposium at the Chapman Cultural Center earlier this month. “So there’s this kind of cultural sensitization that you’re not really sick unless you feel really down.”

DeLisa said that strong, historical ties to religion also keep people from seeking treatment.

“People will see signs and symptoms,” she said. “they will just pray over it and let it go.”

On another level, cultural folk remedies and old wives’ tales filter through generations and persist despite leaps in medicine and medical technology.

Harris said she remembers her great-grandmother, the daughter of slaves, using herbal tea for medicine.

She disavows her family’s folk medicine but, like many African-Americans, won’t register as an organ donor.

“That’s just the culture that I was raised in,” she said. “Many slaves believed that, when they died, their bodies went back to Africa, and if you don’t have all your parts, your people might not know you when you arrive on the other side.”

At the Gibbs Cancer Center at Spartanburg Regional, staff members were concerned that minorities — specifically black men — were dying of prostate cancer at high rates, and they were being diagnosed at late stages.

African-American men have a higher mortality rate from prostate cancer and need examinations earlier in life, said Lucy Gansauer, director of the National Cancer Institute Community Cancer Centers Program at Gibbs.

Gansauer said the cancer center has been focused on reaching out to black men about this issue.

But it hasn’t been easy.

“they don’t like to have a digital rectal exam,” DeLisa said. “Well, I’m thinking, who does? a lot of guys don’t like the idea of a doctor being that personal with them.”

Gansauer said that their campaign has helped increase the numbers of black men who receive prostate screenings, which help diagnose cancer at an earlier and less lethal stage.

Like these targeted campaigns for prostate cancer screenings, making health equitable for all Americans takes a day-to-day commitment to reducing the historical gap in the types of health care that different groups of Americans receive, Petrofes said.

“The same opportunities were not afforded to everyone in the same way,” he said.