Healthy People 2000 Citizens Chart the Course (1990) / Chapter Skim
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6 Racial and Ethnic Minorities
6 Racial and Ethnic Minorities
Pages 51-63
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From page 51... ...
Despite current limits to data on minority populations, testifiers were able to discuss specific health needs and disease patterns of Blacks, Hispanics, Native Americans, Asians, and Arab Americans in the United States. The emergent picture is that health promotion and disease prevention efforts have not yet closed the gap in health status between the majority population and racial or ethnic minorities.
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From page 52... ...
It also discusses specific health problems affecting Blacks, Hispanics, and Native Americans that are amenable to prevention and the implications for establishing realistic and viable national health objectives for these disparate populations. SOCIAL, BEHAVIORAL, AND CULTURAL FACTORS To design better interventions to improve the health status of minorities, the social, economic, genetic, behavioral, and cultural factors that divide racial or ethnic minorities and the majority population must be understood.
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From page 53... ...
This abuse is harmful not only because of its immediate effect on the individual's well-being but also, as Joseph says, because substance abuse is a dynamic that is integral to all major health problems. (#43 7J Although there has been much concern recently over the spread of AIDS through intravenous drug abuse and the onslaught of crack cocaine, the effects of tobacco and alcohol abuse cause substantially more mortality and morbidity among minority groups such as Hispanics, Blacks, and Native Americans.
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From page 54... ...
54 Healthy People 2000: Citizens Chart the Course Differentials between Black and White utilization of medical services have declined since the 1960s, in large part because of Medicaid and Medicare; in some cases, Blacks have higher utilization rates than Whites.~6~7 When Blacks do seek care, however, they are more likely than Whites to receive it in emergency rooms. This arrangement is obviously not conducive to preventive care, screening sentences, or the continuity of care needed for health promotion efforts, says Freeman.
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From page 55... ...
However, Rebecca Work of the American College of Nurse-Midwives says that in recent years, many programs have been terminated and policies reversed.24 (~268J Thus, the increase in numbers of Black, Hispanic, and Native American physicians and the concomitant strides in cultural sensitivity and commitment to minority communities have been halted. SPECIFIC HEALTH PROBLEMS OF MINORITY GROUPS There are nearly 6O,000 excess Black deaths yearly, according to the Report of the Secretary's Task Force on Black and Minored Health; that is, if Blacks had the same age- and sex-specific death rates as Whites, 60,000 fewer Blacks would die each year.
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From page 56... ...
In 1987 the mortality rate for heart disease was 287 per 100,000 for Black males, compared to 226 per 100,000 for White males, and 181 per 100,000 for Black females, compared to 116 per 100,000 for White females. For Black and White males, stroke rates were 57 versus 30 per 100,000, respectively; for Black and White women, they were 46 versus 26 per 100,000, respectively.27 Both the Hispanic and Black populations also have significant problems with obesity, high serum cholesterol levels, and high blood pressure, all of which are risk factors for cardiovascular disease.
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From page 57... ...
According to testimony, one of the great differences in disease status between Hispanics and Whites is the rate of diabetes. Native Americans also have especially high rates of diabetes, according to Spero Manson of the University of Colorado Health Sciences Center.
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From page 58... ...
The lifetime risk for homicide is ~ in 21 for Black men and 1 in 104 for Black women. In comparison, the risk for White men is 1 in 131 and for White women, 1 in 369.34 "As a Black psychiatrist practicing community psychiatry in a predominantly Black communing on the south side of Chicago," says Carl Bell, Executive Director of the Community Mental Health Council, "I have seen the lethal and nonlethal effects of interpersonal violence firsthand.
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From page 59... ...
Tobacco, Alcohol, and Substance Abuse The prevalence of cigarette smoking in the Black community is a distressing sign of the gap between White and Black health behaviors. Smoking rates are 39 percent for Black men age 18 or older and 27 percent for Black women, whereas the rates are 30 percent for White males and 27 percent for White females.36 Although Black men tend to be lighter smokers than White men, successful interventions to reduce the smoking rate in this population are not widespread, according to Hargreaves.
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From page 60... ...
(~016) Louis Bernard, Dean of Diehard Medical College, supports Batiste's view and reports that unwanted childbearing in the Black community is especially high among teenagers and is exacerbated by Lack of income and job protection, limited access to essential services, and the indifference of society to their aspirations." (i¢253J Smith discusses the problems of adolescent pregnancy in the Hispanic population in Texas.
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From page 61... ...
U.S. General Accounting Office: Prenatal care: Medicaid recipients and uninsured women obtain insufficient care.
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From page 62... ...
235 Bruhn, John; University of Texas Medical Branch at Galveston 253 Bernard, Louis; Meharry Medical College 255 Blumenthal, Daniel; Morehouse School of Medicine 256 Mauer, Alvin and Arreola, Mona; University of Tennessee, Memphis 261 Thomas, John and Neser, William; Mehar~y Medical College 268 Work, Rebecca; University of Alabama at Birmingham 269 Ahmed, Osman; Meharty Medical College 273 DiClemente, Ralph; University of California, San Francisco 279 Davidson, Ezra; King-Drew Medical Center (Los Angeles) 308 Smith, Peggy B.; Baylor College of Medicine 314 Wailer, John; Wayne State University 358 Thompson, Alvin; University of Washington 371 Schiff, Donald; American Academy of Pediatrics 389 Sail, James; Detroit Department of Health 437 Joseph, Stephen; New York City Department of Health 62 Healthy People 2000: Citizens Chart the Course
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From page 63... ...
688 Kay, Clyde; Louisiana Primary Care Association 690 Carr, Katherine; American College of Nurse-Midwives 706 Manson, Spero; University of Colorado Health Sciences Center 723 Morrison, Jacqueline; Wayne State University 743 Crawford, Michael; Universitr of Texas Health Science Center at San Antonio 745 Flores, George; Metropolitan Health District, San Antonio Racial and Ethnic Minorities 63
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