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For minorities, the health playing field may not be level

Host of reasons have led to differences in incidence, prevalence of disease

By Dennis Thompson
HealthDay Reporter

(HealthDay News) -- Though minorities in the United States face an array of challenges, chief among them may be personal health and well-being.

African Americans, Hispanic Americans and other minority groups are more likely than whites to develop a number of chronic and deadly diseases, according to a mounting pile of evidence.

Infant mortality, obesity, diabetes, cancer, cardiovascular disease and communicable diseases are among the wide range of health issues for which minorities find themselves at greater risk than whites, according to the U.S. Centers for Disease Control and Prevention.

"The evidence of health disparities would be easy to ignore were they not so well-documented," said Stephen B. Thomas, director of the Center for Health Equity and a professor of health services administration in the School of Public Health at the University of Maryland. "Members of racial minority groups live sicker and die younger than their white counterparts."

National Minority Health Month, observed in April, provides a chance to reflect on these health disparities and how they might be overcome.

Researchers have identified a number of factors that help create the various health disparities, among them location, socioeconomic status and access to health insurance and quality health care, said Garth Graham, deputy assistant secretary for minority health at the U.S. Department of Health and Human Services.

"There are some common factors," Graham said. "There is no one common cause, but there are common factors."

The federal government has swung into action on the issue, creating a new institute within the National Institutes of Health to focus on minority health disparities.

The National Institute on Minority Health and Health Disparities, which came into being in September as part of the government's larger health-care reform effort, has been charged with researching differences in incidence and prevalence of disease among America's population groups.

According to the CDC, health disparities that have been identified include:

  • Infant mortality. The infant death rate among African Americans and American Indians is more than double that of whites.
  • Obesity. African Americans and Mexican Americans are more likely than whites in the United States to be obese, a condition that increases the chances of developing a number of other health problems.
  • Diabetes. Hispanics in the United States are nearly twice as likely to die from diabetes as are whites. American Indians have a diabetes rate equal to that of whites.
  • Cardiovascular disease. Death rates from heart disease are more than 40 percent higher for African Americans than for whites.
  • Cancer. The death rate for all cancers is 30 percent higher for African Americans than it is for whites. African American women have a higher death rate from breast cancer, even though they are screened for breast cancer at nearly the same rate as white women. "More white women develop breast cancer, but more black women die from breast cancer," Thomas said.
Why is this happening?

Some health problems have been linked to genetic predisposition. For example, African Americans are more likely to have sickle cell anemia than other racial groups, Graham said.

But research has found that the problem of health disparities in America also involves a number of societal factors and problems.

Minorities, on average, occupy a lower rung on the socioeconomic ladder, which makes it difficult for them to get quality health care, Graham and Thomas said.

"You have more people who are working in jobs where they are not offered insurance or are offered inadequate insurance," Graham said.

Location also plays a role. Minority groups tend to reside in places that do not lend themselves to healthy living.

"If you end up living in a neighborhood with no sidewalks, that makes it hard to walk for exercise," Thomas said. "If you live in a neighborhood rife with crime and violence, it's very difficult to feel safe to allow your children out to play."

Such places also are often "food deserts," where fast food is readily available but healthy options such as fresh fruit and vegetables are hard to come by, Graham said.

These areas are less likely to have many doctors' offices or health clinics, Graham added, further reducing people's access to health care.

Thomas also cites research that shows racism plays a role in creating health disparities.

"It can be as blatant as minority neighborhoods that do not have doctors' offices in them, and it can be as subtle as not being able to speak the language of your Latino patients," Thomas said.

Overcoming these issues will be key in truly reforming America's health-care system and reducing health costs for everyone, he said. Programs are afoot to encourage doctors to take up shop in lower socioeconomic areas and to promote healthier lifestyle choices among minority groups.

"We cannot afford to have these populations suffer in a whirlpool of preventable illness and death," Thomas said. "This can no longer be, 'That's their problem.' It's all of our problem."

On the Web

The U.S. Centers for Disease Control and Prevention has more on health disparities related to race and ethnicity.

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