© 2010 Jones and Bartlett Publishers, LLC1 Addressing Health Disparities in the 21st Century Chapter 1

© 2010 Jones and Bartlett Publishers, LLC1

Addressing Health Disparities in the 21st Century

Chapter 1


What is your definition of a “health disparities”?



Overview of Health Disparities : Definition Differences in the quality of healthcare that are

not due to access related factor or clinical needs, preferences or appropriateness of intervention.



Definition of Health Disparities Healthy People 2010 “Unequal burden in disease, morbidity

and mortality rates, experienced by ethnic/racial groups as compared to the dominant group”

HRSA : “ Population-specific differences in the presence of disease, health outcome or access to health.

NIH : “Difference in the incidence, prevalence, mortality and burden of disease and other adverse health conditions that exist among specific groups un U.S.”



Education (High School lives longer than a person that has only 9th grade training)

Insurance (most of Hispanics are no insured)

Segregation (poor quality, poor preventive medicine, minorities has the worst health care)

Life style and Health Behavior (poor habits)

Health care provider behavior (physician provide less health care discussion in lower income groups than others, poor understanding of barriers)



Historical Perspectives for Health Disparities Minority Health

African Americans suffer worse health care and health outcomes than Non-Hispanic Whites.

Medical Education In 1920’s only two medical schools trained black physicians.

Poor health outcomes in Black Community.

Contemporary disparities Unequal treatment in health care. Less saving intervention

procedures and increase of undesirables procedures ( i.e., amputation) in minorities.



Statistical Overview of Health Disparities . Prenatal care/ infant mortality Low birth Infant mortality

NA 7.9% AA 5.7% 7.5% 13.6%

Hisp 5.4% 5.6%Asian 3.0%

White 2.2% 2.4% 5.7%

2010 People GOAL is to decrease Infant mortality to 4.6%


Addressing Health Disparities in the 21st Century Preventive Care Black and Latino counseling than non-Hispanic White. Latinos have a risk : Behavior disorders, development disorders,

environment hazard, diabetes, asthma, no insurance, poor quality of care, less help by phone, no health care on time, language barriers.

Asthma increase in AA Adolescents minority unsafe driving, drugs, alcohol, smoking, STDs,

depression.

Pregnancy (15-17 yo) Whites 11.5/1000 Blacks 34.9/1000 Latinos 48.9/1000


Addressing Health Disparities in the 21st Century Obesity Girls Boys Adult AA 26.2% 19.4% 49.7% Mexican 19.4% 27.3% 39.7% White 11.6% 12% 30.0%

Diabetes in minorities AA and Hispanics Multiple factors (genetic, prematurity, low birth wt, breast feeding, stress, diet,

habits)

Adult Preventive Care Most of the Hispanics between 18-64 yo NO preventive care. Low screening test

evaluation. NO care older than 12 mo of age : 27% Hispanics, 21% Asian, 18% AA, 14% Non-Hispanic Whites

Elderly Health End of Life Care


Addressing Health Disparities in the 21st Century Progress on Eliminating Disparities

HEALTHY PEOPLE 2010In 2005 midpoint reported significant improvements in

health.

Health Workforce Education Less than 4% of Physicians are Hispanic and 5.3%

are AA 5.9% graduate from Medical School are Hispanic


1. Why should we eliminate health disparities?

2. What are some potential strategies?



Solutions Improving clinical care

(communities/academic) Improving health promotions/ prevention Improving diversity in the health care force Improve patient/provider communication Improve workforce cultural competencies Increase research and policy changes

Documents

© 2010 Jones and Bartlett Publishers, LLC1 Addressing Health Disparities in the 21st Century Chapter 1