Eliminating Racial & Ethnic Health Disparities


"The future health of the nation will be determined to a large extent by how effectively we work with communities to reduce and eliminate health disparities between non-minority and minority populations experiencing disproportionate burdens of disease, disability, and premature death."
~ Guiding Principle for Improving Minority Health


Healthy People 2010 is designed to achieve two overarching goals: 1) Increase quality and years of healthy life; 2) Eliminate health disparities.
The Centers for Disease Control and Prevention and Agency for Toxic Substances and Disease Registry (CDC/ATSDR) has lead or co-lead responsibility for 18 of the 28 (64 percent) Healthy People 2010 focus areas, including all six areas identified in the Department of Health and Human Services (HHS) initiative to eliminate health disparities. The second goal of Healthy People 2010, to eliminate health disparities, includes differences that occur by gender, race or ethnicity, education or income, disability, geographic location, or sexual orientation. Compelling evidence indicate that race and ethnicity correlate with persistent, and often increasing, health disparities among U.S. populations in all these categories and demands national attention.

The demographic changes that are anticipated over the next decade magnify the importance of addressing disparities in health status. Groups currently experiencing poorer health status are expected to grow as a proportion of the total U.S. population; therefore, the future health of America as a whole will be influenced substantially by our success in improving the health of these groups. A national focus on disparities in health status is particularly important as major changes unfold in the way in which health care is delivered and financed.

Eliminating racial and ethnic disparities in health will require enhanced efforts at preventing disease, promoting health and delivering appropriate care. This will necessitate improved collection and use of standardized data to correctly identify all high risk populations and monitor the effectiveness of health interventions targeting these groups.

Eliminating health disparities will also require new knowledge about the determinants of disease, causes of health disparities, and effective interventions for prevention and treatment. It will also require improving access to the benefits of society, including quality preventive and treatment services, as well as innovative ways of working in partnership with health care systems, State and local governments, tribal governments, academia, national and community-based organizations, and communities.

HHS has selected six focus areas in which racial and ethnic minorities experience serious disparities in health access and outcomes: Infant Mortality
African-American, American Indian, and Puerto Rican infants have higher death rates than white infants. In 2000, the black-to-white ratio in infant mortality was 2.5 (up from 2.4 in 1998). This widening disparity between black and white infants is a trend that has persisted over the last two decades.1
Cancer Screening and Management
African-American women are more than twice as likely to die of cervical cancer than are white women and are more likely to die of breast cancer than are women of any other racial or ethnic group.2
Cardiovascular Disease (CVD)
Heart disease and stroke are the leading causes of death for all racial and ethnic groups in the United States. In 2000, rates of death from diseases of the heart were 29 percent higher among African-American adults than among white adults, and death rates from stroke were 40 percent higher.2
Diabetes
In 2000, American Indians and Alaska Natives were 2.6 times more likely to have diagnosed diabetes compared with non-Hispanic Whites, African Americans were 2.0 times more likely, and Hispanics were 1.9 times more likely.3
HIV Infection/AIDS
Although African Americans and Hispanics represented only 26 percent of the U.S. population in 2001, they accounted for 66 percent of adult AIDS cases4 and 82 percent of pediatric AIDS cases reported in the first half of that year.5
Immunizations
In 2001, Hispanics and African Americans aged 65 and older were less likely than Non-Hispanic whites to report having received influenza and pneumococcal vaccines.6


These six health areas were selected for emphasis because they reflect areas of disparity that are known to affect multiple racial and ethnic minority groups at all life stages. The representative near-term goals within these six areas are drawn from Healthy People 2000, the Nation's prevention agenda: targets for reducing disparities have been developed in consultation with representatives from target communities and experts in public health. Reliable national data is also available to track our progress on these near-term goals in a timely fashion. The leadership and resource of the Department will be committed to achieving significant reductions in these disparities by the year 2010. These disparities occur for a variety of reasons, including unequal access to health care, discriminations, and language and cultural barriers.

In addition, the following diseases and conditions disproportionately impact racial and ethnic minorities:

Mental Health
American Indians and Alaska Natives appear to suffer disproportionately from depression and substance abuse. Minorities have less access to, and availability of, mental health services. Minorities are less likely to receive needed mental health services. Minorities in treatment often receive a poorer quality of mental health care. Minorities are underrepresented in mental health research.7
Hepatitis
In 2002, 50 percent of those infected with Hepatitis B were Asian Americans and Pacific Islanders.8 Black teenagers and young adults become infected with Hepatitis B three to four times more often than those who are white.9 One recent study has found that black people have a higher incidence of Hepatitis C infection than white people.10
Syphilis
Some fundamental societal problems, such as poverty, inadequate access to health care, and lack of education are associated with disproportionately high levels of syphilis in certain populations. Cases of primary and secondary syphilis in 1999 had the following race or ethnicity distribution: African Americans 75 percent, whites 16 percent, Hispanics eight percent, and others one percent. Syphilis reflects one of the most glaring examples of racial disparity in health status, with the rate for African Americans nearly 30 times the rate for whites.11
Tuberculosis (TB)
Of all the TB cases reported from 1991-2001, almost 80 percent were in racial and ethnic minorities. Asian Americans and Pacific Islanders accounted for 22 percent of those cases, even though they made up less than four percent of the U.S. population.12

CDC created OMH in 1988 in response to the 1985 Report of the Health and Human Services (HHS) Secretary’s Task Force on Black and Minority Health which revealed large and persistent gaps in health status among Americans of different racial and ethnic groups. Since September 2001, OMH has engaged its partners in anticipating, preparing, and responding to the needs of racial and ethnic minority populations during public health emergencies. OMH provides leadership in setting priorities and monitors and evaluates programs geared toward eliminating the disproportionate burden of disease, illness and disability among racial and ethnic minority populations through research, enhanced health practices, health promotion and services