Synopsis for January 14, 2005

The MMWR is embargoed until Thursday, 12 PM EDT.

1. Health Disparities Experienced by Black or African Americans ― United States
2. Differences in Disability Among Black and White Stroke Survivors ― United States, 2000-2001
3. Racial/Ethnic Disparities in Prevalence, Treatment, and Control of Hypertension ― United States, 1999-2002
4. Racial Disparities in Nationally Notifiable Diseases ― United States, 2002
5. Reducing Childhood Asthma Through Community-Based Service Delivery ― New York City 2001-2004
6. Update: Influenza Activity ― United States, 2004-05 Season

Health Disparities Experienced by Black or African Americans ― United States

Insufficient resources at the community level and unequal use of effective interventions maintain the black-white gap in avoidable illness, injury and premature death. To improve the health status of African Americans and close the black-white gap at the same time, effective interventions and adequate resources must be available to all Americans in relation to their needs. Disadvantaged black communities will need additional resources and optimal use of effective interventions that are culturally appropriate.

For certain health conditions, non-Hispanic black Americans bear disproportionate burdens of disease, injury, death, and disability. Seven of the 10 leading causes of death are the same for non-Hispanic black Americans and non-Hispanic white Americans (the largest racial/ethnic population in the United States); but three of the 10 leading causes of death for non-Hispanic black Americans are not among the leading causes of death for non-Hispanic white Americans: homicide (sixth), human immunodeficiency virus (HIV) disease (seventh), and septicemia (ninth). Moreover, the rates of avoidable illness and death from the top ten diseases and injuries and their risk factors often are greater among black Americans than white Americans.

Differences in Disability Among Black and White Stroke Survivors ― United States, 2000-2001

Improvements in stroke survival and reduction of disability might be influenced by reducing health disparities in the prevention, treatment, and control of risk factors of stroke, which include high blood pressure, diabetes, obesity, and inadequate levels of physical activity. By creating culturally appropriate public education messages to increase awareness of stroke signs and symptoms and the need to promptly call 911 to reduce treatment delay might reduce stroke-related disabilities.

In 2000-2001, there were a total of 1, 391 non-institutionalized stroke survivors that participated in the Sample Adult portion of the National Health Interview Survey. African-Americans were significantly more likely than whites to report limitations in performing all activities considered in this study. For example, 42.4 percent of African- Americans reported walking up 10 steps without resting as “very difficult” or “can’t do at all” compared to 28.6 percent of whites. Additionally, 50.1 percent of African-Americans reported using special equipment compared to 35.6 percent of whites. African-Americans were also significantly more likely than whites to mention stroke as one of the health conditions causing limitations in performing certain activities.

Racial/Ethnic Disparities in Prevalence, Treatment, and Control of Hypertension ― United States, 1999-2002

The findings of this report demonstrate continuing racial/ethnic disparities in the prevalence of hypertension, in the percentages of those who are hypertensive and aware of it, those who are being treated for their hypertension, and those with adequate control of their hypertension. Because of the serious health consequences associated with HBP, greater efforts are needed to prevent HBP and/or improve BP control and HBP diagnosis rates among all groups. Greater efforts are specifically needed to improve HBP prevention among non-Hispanic blacks, and to increase HBP treatment and control among Mexican-Americans who have lower rates of treatment and control, compared to other race/ethnic groups.

High blood pressure (HBP) is a major risk factor for heart disease and stroke, end-stage renal disease, and peripheral vascular disease and is a chief contributor to adult disability. During the last decade, the prevalence of hypertension increased and the percentage of those with high blood pressure (HBP) who are aware of their condition increased among non-Hispanic whites, non-Hispanic blacks, and Hispanics. Although treatment and control of hypertension also increased in the U.S. between 1988 and 2000, percentages remained low for some ethnic minorities. The age-adjusted prevalence of hypertension was 40.5 percent among non-Hispanic blacks, 27.4 percent among non-Hispanic whites, and 25.1 percent among Mexican-Americans. Findings suggest that despite some progress, racial/ethnic disparities in the prevalence of hypertension and Americans’ awareness of, treatment for and control of HBP still persist.

Racial Disparities in Nationally Notifiable Diseases ― United States, 2002

No Summary Available.

Reducing Childhood Asthma Through Community-Based Service Delivery ― New York City 2001-2004

A community-based program effectively reduced asthma morbidity among children in Central Harlem, where prevalence of childhood asthma is high.

The Harlem Children's Zone Asthma Initiative documented a high prevalence (>30 percent) of asthma or asthma-like signs among children (<12 years) in Central Harlem, New York City. Preliminary data (2001-2004) showed the initiative reduced asthma morbidity (measured for 13 asthma symptoms and management strategies). In 18 months, school absences because of asthma declined from nearly 24 percent to 8 percent, and emergency department and unscheduled physician office visits for treatment of asthma decreased from 35 percent to 8 percent. A pediatric asthma team (including community workers, social worker, nurse, and physicians) offered medical, educational, environmental, social, and legal services to families of enrolled children, and the community workers monitored participants via home visits. The effectiveness achieved underscores the utility of community-based public health programs in reducing asthma morbidity.

Update: Influenza Activity ― United States, 2004-05 Season

No summary available.

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