Health Disparities Experienced by Black or African Americans - USA

Main Category: Public Health
Article Date: 14 Jan 2005 - 11:00 PDT

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In the 2000 census, 36.4 million persons, approximately 12.9% of the U.S. population, identified themselves as Black or African American; 35.4 million of these persons identified themselves as non-Hispanic (1). For many health conditions, non-Hispanic blacks bear a disproportionate burden of disease, injury, death, and disability. Although the top three causes and seven of the 10 leading causes of death are the same for non-Hispanic blacks and non-Hispanic whites (the largest racial/ethnic population in the United States), the risk factors and incidence, morbidity, and mortality rates for these diseases and injuries often are greater among blacks than whites. In addition, three of the 10 leading causes of death for non-Hispanic blacks are not among the leading causes of death for non-Hispanic whites: homicide (sixth), human immunodeficiency virus (HIV) disease (seventh), and septicemia (ninth). This week's MMWR is the third in a series* focusing on racial/ethnic health disparities. Eliminating these disparities will require culturally appropriate public health initiatives, community support, and equitable access to quality health care.

In 2002, non-Hispanic blacks who died from HIV disease had approximately 11 times† as many age-adjusted years of potential life lost before age 75 years per 100,000 population as non-Hispanic whites. Non-Hispanic blacks also had substantially more years of potential life lost than non-Hispanic whites for homicide (nine times as many), stroke (three times as many), perinatal diseases (three times as many), and diabetes (three times as many) (2).

Cancer is the second leading cause of death for both non-Hispanic blacks and non-Hispanic whites. However, in 2001, the age-adjusted incidence per 100,000 population was substantially higher for black females than for white females for certain cancers, including colon/rectal (54.0 versus 43.3), pancreatic (13.0 versus 8.9), and stomach (9.0 versus 4.5) cancers. Among males, the age-adjusted incidence was higher for black males than for white males for certain cancers, including prostate (251.3 versus 167.8), lung/bronchus (108.2 versus 72.8), colon/rectal (68.3 versus 58.9), and stomach (16.3 versus 10.0) cancers (3).

Stroke is the third leading cause of death for both non-Hispanic blacks and non-Hispanic whites. However, during 1999--2002, non-Hispanic black males and females aged 20--74 years had higher† age-adjusted rates per 100,000 population of hypertension than their white counterparts (36.8 versus 23.9 for males; 39.4 versus 23.3 for females) (4).

Racial/ethnic health disparities are reflected in leading indicators of progress toward achievement of the national health objectives for 2010 (5). In 2002, non-Hispanic blacks trailed non-Hispanic whites in at least four positive health indicators†, including percentages of 1) persons aged <65 years with health insurance (81% of non-Hispanic blacks versus 87% of non-Hispanic whites), 2) adults aged >65 years vaccinated against influenza (50% versus 69%) and pneumococcal disease (37% versus 60%), 3) women receiving prenatal care in the first trimester (75% versus 89%), and 4) persons aged >18 years who participated in regular moderate physical activity (25% versus 35%). In addition, non-Hispanic blacks had substantially higher proportions of certain negative health indicators than non-Hispanic whites, including 1) new cases of gonorrhea (742 versus 31 per 100,000 population; 2002 data), 2) deaths from homicide (21.6 versus 2.8; 2002 data), 3) persons aged 6--19 years who were overweight or obese (22% versus 12%; 2000 data), and 4) adults who were obese (40% versus 29%; 2000 data).

Since the 1970s, racial/ethnic disparities in measles cases and measles-vaccine coverage have been all but eliminated (6). However, during 1996--2001, the vaccination-coverage gap between non-Hispanic white and non-Hispanic black children widened by an average of 1.1% each year for children aged 19--35 months who were up to date for the 4:3:1:3:3 series of vaccines (recommended to prevent diphtheria, tetanus, and pertussis; polio; measles; Haemophilus influenzae type b disease; and hepatitis B) (7). In 2002, among children aged 19--35 months, 68% of non-Hispanic black children were fully vaccinated, compared with 78% of non-Hispanic white children…….. CONTINUES………….CDC-MMWR

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