Health Gap Between Whites, Minorities Narrows in 1990s, But Disparities Remain

Although the health gap between whites and minorities narrowed in the 1990s, "substantial" disparities remain, according to a new CDC report released yesterday, the Los Angeles Times reports. In 1990, the federal government launched an "ambitious" initiative, called "Healthy People 2000," which was designed to improve Americans' health and reduce racial disparities (Garvey, Los Angeles Times, 1/25). The report, titled "Trends in Racial and Ethnic-Specific Rates for the Health Status Indicators: United States, 1990-98," examined 17 health status indicators from 1990-1998 (Keppel et al., "Trends in Racial and Ethnic-Specific Rates for the Health Status Indicators: United States, 1990-98," January 2002). All racial and ethnic groups showed improvement in 10 of the indicators including prenatal care, infant mortality, teen births, death rates for heart disease, and tuberculosis and syphilis case rates. For five indicators -- total death, death rates for stroke, lung cancer, and breast cancer and suicide -- all groups except American Indians and Alaska Natives showed improvement. However, the report found that for about 50% of the indicators, disparities improved "only slightly" (HHS release, 1/24). The report's findings include:

• The overall percentage of low-weight babies rose from 7% to 7.6% -- the only health indicator to increase.
  
• Non-Latino black Americans were eight times more likely than whites to contract tuberculosis, even though the tuberculosis rate for blacks fell 50%.
  
• While the breast cancer death rate for white women fell 19%, the rate for black women only dropped 4%.
  
• Twelve percent of white women received no prenatal care during the first trimester of pregnancy, compared to 17% of Asian women, 27% of black women, nearly 26% of Latino women and more than 30% of American Indians or Alaskan natives.

Federal health officials, however, noted that "large gains" were made in areas where certain communities were targeted for care, citing the significant "cut[s]" in syphilis case rates in black and Latino communities (Los Angeles Times, 1/25). Syphilis rates among non-Hispanic blacks declined 88% between 1990 and 1998, while rates dropped 90% among Hispanics during the same period ("Trends in Racial and Ethnic-Specific Rates for the Health Status Indicators: United States, 1990-98," January 2000). The syphilis case reduction is attributed to an "intensive campaign to eradicate syphilis community by community," according to Dr. Jeffrey Koplan, CDC director. He added, "A clear lesson for public health is that efforts to achieve progress for all must be targeted and tailored to the needs of specific groups" (HHS release, 1/24). Still, even with the targeted programs, the rate of syphilis cases was 34 times as high for blacks and 3 times as high for Latinos as for whites (Los Angeles Times, 1/25). CDC researchers said the reasons for the disparities were "different for each indicator and even for different parts of the country." Ken Kettel, a CDC statistician and lead author of the report, said, "Certainly some are due to social and economic factors and other behavioral factors" (AP/New York Times, 1/25). Thompson said, "Our goal is to eliminate disparities in health among all population groups by 2010. While we are making progress, this report shows how far we still have to go" (HHS release, 1/24). The report is available at http://www.cdc.gov/nchs/data/statnt/statnt23.pdf. Note: You must have Adobe Acrobat Reader to view the report.