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Disparities
In its 2002 publication, “ Unequal Treatment: Confronting Racial and
Ethnic Disparities in Health Care,” the Institute of Medicine reports that racial and ethnic minorities tend to receive a lower quality of health care than nonminorities, even when patients’ insurance status and income are controlled. The study committee found evidence that stereotyping, biases, and uncertainty on the part of health
care providers all contribute to unequal treatment. The report calls for cross-cultural training for providers.
Cultural competence can have a real impact on clinical outcomes. Ignoring culture can lead to negative health consequences in many ways. For example, patients may choose not to seek needed services for fear of being misunderstood or disrespected, and patients may not adhere to medical advice because they do not understand
or do not trust the provider. Providers may not order appropriate tests or medical interventionsdue to cross-cultural misunderstandings.
In this section, we will provide statistics about health disparities effecting racial and ethnic minorities in the United States, related to specific diseases, in order to increase awareness of health disparities effecting racial and ethnic minorities and promote cross-cultural understanding. For more information on health disparities, please consult our online resource guide to health disparities.
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The death rate from cancer among African-American males is
1.4 times higher than that among white males; for African-American females, it is 1.2 times higher.
– American Cancer Society, “Cancer Facts & Figures 2004,” (2004)
African-American men have a rate of prostate cancer that
is double that for white men.
– Health Resources Service Administration (HRSA), “Eliminating Health Disparities in the United States,” (2000)
The incidence rate for invasive cervical cancer, which is largely preventable
by screening, is four times as high among Vietnamese women compared to
all Asian American and Pacific Islander populations combined.
– American Cancer Society, “Cancer Facts & Figures 2004,” (2004)
In the United States, the rates of stomach cancer incidence are
at least 75% higher in Hispanics than in non-Hispanic whites.
– American Cancer Society, “Cancer Facts & Figures for Hispanics/Latinos 2003-2005,” (2003)
In the United States, the incidence and mortality rate of stomach,
uterine cervix, liver and biliary tract cancers are higher among Hispanics
than non-Hispanic whites, and are especially high among first generation
migrants to the U.S.
– American Cancer Society, “Cancer Facts & Figures for Hispanics/Latinos 2003-2005,” (2003)
During 1992-2000 incidence rates for breast cancer increased
overall in Asian and Pacific Islanders (2.1% per year).
– American Caner Society, “Breast Cancer Facts & Figures 2003-2004,” (2003)
African Americans with diabetes are more likely to develop diabetes complications and experience greater disability from the complications than white Americans with diabetes.
– National Diabetes Information Clearinghouse (NDIC), “Diabetes in African Americans,” (2002)
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Death rates for people with diabetes are 27 percent higher for African Americans compared with whites.
– National Diabetes Information Clearinghouse (NDIC), “Diabetes in African Americans,” (2002)
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– National Diabetes Information Clearinghouse (NDIC), “Diabetes in Hispanic Americans,” (2002)
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Diabetes is particularly common among middle-aged and older
Hispanic Americans. For those age 50 or older, about 25 to 30
percent have either diagnosed or undiagnosed diabetes.
–- National Diabetes Information Clearinghouse (NDIC), “Diabetes in Hispanic Americans,” (2002)
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As in all populations, having risk factors for diabetes increases the chance that a Hispanic American will develop diabetes. Risk factors seem to be more common among Hispanics than non-Hispanic whites. These factors include a family history of diabetes, gestational diabetes, impaired glucose tolerance, hyperinsulinemia and insulin resistance, obesity, and physical inactivity.
– National Diabetes Information Clearinghouse (NDIC), “Diabetes in Hispanic Americans,” (2002)
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Prevalence data for Asian and Pacific Islander Americans are limited, but studies have shown that some groups within this population are at increased risk for developing type 2 diabetes compared with non-Hispanic white people in the United States.
–- National Diabetes Information Clearinghouse (NDIC), “Diabetes in Asian and Pacific Islander Americans,” (2002)
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Studies have shown that, for many Asian Americans, their diet in America is higher in calories and fat and lower in fiber than in their countries of origin. Changes in diet combined with decreased physical activity have increased risk factors for type 2 diabetes among some Asian Americans.
– National Diabetes Information Clearinghouse (NDIC), “Diabetes in Asian and Pacific Islander Americans,” (2002)
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About 15 percent of American Indians and Alaska Natives who
receive care from the Indian Health Service have diabetes, mostly
type 2 diabetes. Rates vary markedly among tribes.
– National Diabetes Information Clearinghouse (NDIC), “Diabetes in American Indians and Alaska Natives,” (2002)
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American Indians and Alaska Natives with diabetes have a high incidence of diabetes complications such as eye and kidney disease, cardiovascular disease, and lower extremity amputations.
–- National Diabetes Information Clearinghouse (NDIC), “Diabetes in American Indians and Alaska Natives,” (2002)
Cardiovascular Disease Link above
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African Americans suffer the most from the disease.Around 40 percent
of African American men and women have some form of heart disease, compared to 30 percent of White men and 24 percent of White women. African Americans are also 29 percent more likely to die from the disease than Whites.
– Closing the Health Gap, Office of Minority Health (OMH),” Heart Disease”
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While Hispanics die from heart disease at a lesser rate than Whites,
Mexican American women are diagnosed with the condition more frequently than White females. Mexican Americans, who make up the largest share of the U.S. Hispanic population, also suffer in greater numbers from overweight and obesity than Whites, two of the leading risk factors for heart disease.
– Closing the Health Gap, Office of Minority Health (OMH),” Heart Disease”
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More than 25 percent of deaths in the Asian and Pacific Islander community and 20 percent of deaths in the American Indian community are caused by heart disease.
–- Closing the Health Gap, Office of Minority Health (OMH),” Heart Disease”
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Among American Indians/Alaska Natives age 18 and older, the following
have one or more CVD risk factors (hypertension, current cigarette smoking, high blood cholesterol, obesity, or diabetes): 63.7% of men and 61.4% of women.
– American Heart Association, “American Indians/Alaska Natives and Cardiovascular Disease—Statistics,” (2004)
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AIDS is the leading cause of death among African-American men ages 25-44
– National Institute of Allergy and Infectious Disease, “HIV Infection in Minority Populations,” (2003)
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A study of people diagnosed with HIV found that 56% of “late testers,
” i.e., those that were diagnosed with AIDS within one year of their HIV
diagnosis, were African American. Late testing represents missed opportunities in prevention and treatment of HIV
– Center for Disease Control and Prevention (CDC), “HIV/AIDS Among African Americans,” (2004)
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In 2000, Hispanics represented 13% of the U.S. population
(including residents of Puerto Rico), but accounted for 19%
of the total number of new U.S. AIDS cases reported that year
(8,173 of 42,156 cases).
– Center for Disease Control and Prevention (CDC), “HIV/AIDS Among Hispanics in the United States, (2002)
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The AIDS incidence rate per 100,000 population (the number of new cases of a disease that occur during a specific time period) among Hispanics in 2000 was 22.5, more than 3 times the rate for whites (6.6), but lower than the rate for African Americans (58.1).
– Center for Disease Control and Prevention (CDC), “HIV/AIDS Among Hispanics in the United States, (2002)
Online Resource Guide to Health Disparities: Link above
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Health Resources Services Administration (HRSA),
U.S. Department of Health and Human Services (DHHS)
http://www.hrsa.gov/
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Office of Minority Health (OMH), U.S. Department of Health and Human Services (DHHS)
http://www.omhrc.gov/
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