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Last Reviewed: June 5, 2007
Content Source:
Office of Minority Health & Health Disparities (OMHD)

Disease Burden & Risk Factors

Healthy People 2010, the Nation's prevention agenda, is designed to achieve two overarching goals: 1) Increase quality and years of healthy life; 2) 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. Because racial and ethnic minority groups are expected to comprise an increasingly larger proportion of the U.S. population in coming years, the future health of America will be greatly influenced by our success in improving the health of these groups. Despite great improvements in the overall health of the nation, Americans who are members of racial and ethnic minority groups, including blacks or African Americans, American Indians and Alaska Natives, Asian Americans, Hispanics or Latinos, and Other Pacific Islanders, are more likely than whites to have poor health and to die prematurely.  These disparities are believed to be the results of the complex interaction among genetic variations, environmental factors, and specific health behaviors.

Culturally appropriate, community-driven programs are critical for eliminating racial and ethnic disparities in health. For these programs to be effective, prevention research is needed to identify the causes of health disparities and the best means of delivering preventive and clinical services. Establishing these programs will also require new and innovative partnerships among federal, state, local, and tribal governments and communities.

The Department of Health and Human Services (HHS) has selected six focus areas in which racial and ethnic minorities experience serious disparities in health access and outcomes:

maroon square 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.1
maroon square 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.1
maroon square 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.2
maroon square 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 cases3 and 82 percent of pediatric AIDS cases reported in the first half of that year.4
maroon square 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.5
maroon square 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.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:

maroon square 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
maroon square 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
maroon square 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
maroon square 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


1 National Center for Health Statistics (NCHS), Health, United States, 2002, Table 30.
  2 National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), 2000.
  3 NCHS, Health, United States, 2002, Table 54.
  4 NCHS, Health, United States, 2002, Table 55.
5 Morbidity and Mortality Weekly Report (MMWR), 2002, p.1020.
6 National Center for Health Statistics (NCHS), 2002.
7 Mental Health: A Report of the Surgeon General, 1999.
  8 Department of Health and Human Services.
9 Marwick C, Mitka M (1999). Debate revived on hepatitis B vaccine value. JAMA, 282(1): 15–17.
10 Committee on Infectious Diseases, American Academy of Pediatrics (2000). Hepatitis C. In LK Pickering et al., eds., 2000 Red Book: Report of the Committee on Infectious Diseases, 25th ed., pp. 302–306. Elk Grove, IL: American Academy of Pediatrics.
11  National Center for HIV, STD, and TB Prevention (NCHSTP) Division of Sexually Transmitted Diseases.
12  NCHSTP Division of TB Elimination.

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