Racial, Ethnic Health Disparities Persist in US, CDC Says

Megan Brooks

April 28, 2016

Although there has been progress toward health equality in the United States, health disparities among racial and ethnic groups persist, according to the Centers for Disease Control and Prevention (CDC's) 39th annual report card on the nation's health, released yesterday.

This year's report card includes a special feature on racial and ethnic health disparities, inspired by the landmark 1985 Heckler Report, which documented significant health disparities among racial and ethnic groups.

Racial and ethnic groups in the United States have made gains in infant death rates, number of women who smoke, and numbers of uninsured, but gaps remain in obesity, cesarean births, and dental care, according to the report, prepared by the CDC's National Center for Health Statistics and released by the US Department of Health and Human Services.

"We have seen important improvements in some health measures for racial and ethnic minority populations since the Heckler Report elevated minority health onto a national stage in 1985," J. Nadine Gracia, MD, MSCE, deputy assistant secretary for minority health and director of the US Department of Health and Human Services Office of Minority Health, said in a news release. "While there has been significant progress in our journey toward health equity, disparities still exist and we must remain vigilant in our efforts to end health disparities in America," she added.

Highlights of the Special Feature

  • For infant mortality, the difference between the highest (blacks) and lowest (Asian or Pacific Islander) infant death rates among the five racial and ethnic groups narrowed from 9.41 deaths per 1000 live births in 1999 to 7.21 in 2013.

  • For low-risk cesarean deliveries, black mothers had the highest percentage (29.9% in 2014) among the five racial and ethnic groups, whereas American Indian or Alaska Native mothers had the lowest (21.5% in 2014). Among Hispanics, Cuban mothers had the highest percentage of low-risk cesarean deliveries among the five Hispanic groups (41.4% in 2014), whereas Mexican mothers had the lowest (24.1% in 2014).

  • For women, the difference between the highest (white) and lowest (Asian) percentages of current cigarette smokers among racial/ethnic groups narrowed from 17.5 percentage points in 1999 to 13.2 in 2014.

  • For insurance coverage, the difference between the highest and lowest percentage of uninsured adults aged 18 to 64 years narrowed from 24.9 percentage points in 1999 (Hispanics compared with non-Hispanic whites) to 19.9 percentage points in the first 6 months of 2015 (Hispanics versus non-Hispanic Asians).

  • For childhood obesity (2011 - 2014), Hispanics aged 2 to 19 years had the highest rate of obesity (21.9%); their Asian peers had the lowest rate (8.6%).

  • For dental care, in 2014, Hispanic adults aged 18 to 64 years were most apt to go without needed dental care (15.7%) because of cost compared with just 6.3% of Asian adults.

Nation's Health Overall

And here's a sampling of highlights from the full 461-page report on the nation's health overall:

  • In 2014, life expectancy in the United States was 78.8 years: 76.4 for males and 81.2 for females.

  • In 2014, the 10 leading causes of death were heart disease, cancer, chronic lower respiratory diseases, unintentional injuries, stroke, Alzheimer disease, diabetes, influenza and pneumonia, kidney disease, and suicide. These 10 causes of death accounted for 74% of the 2.6 million deaths in 2014.

  • Between 2004 and 2014, the age-adjusted death rate for heart disease and cancer decreased by 25% and 14%, respectively; the suicide death rate increased 21%; and the drug poisoning death rate involving heroin jumped more than five times, going from 0.6 to 3.3 deaths per 100,000.

  • In 2011 to 2014, one third of adults aged 20 years and older had hypertension (having measured high blood pressure or reporting taking antihypertensive medication), and nearly one half (47.0%) had uncontrolled high blood pressure.

  • Between 2003 and 2013, the incidence rates of four notifiable diseases — tuberculosis, hepatitis A, hepatitis B, and meningococcal disease — decreased, whereas the incidence rates of Lyme disease increased 57% and rates of pertussis more than doubled, to 9.12 new cases per 100,000 population in 2013. Despite the long-term decline in acute hepatitis B cases, 2012 to 2013 saw a 5% increase in the number of reported cases.

  • In 2014, only about 21% of adults aged 18 years and older met the 2008 federal physical activity guidelines for both aerobic activity and muscle strengthening.

  • Between 2013 and 2014, rates of uninsured adults aged 18 to 64 years declined by 28% in states that expanded Medicaid programs to include low-income adults compared with a decline of 14% in states that did not expand Medicaid programs.

  • In 2014, Massachusetts (3.9%), Vermont (5.4%), Hawaii (5.7%), and the District of Columbia (6.1%) had the lowest percentages of persons uninsured among those younger than 65 years, whereas Alaska (19.2%), Florida (20.1%), and Texas (21.2%) had the highest percentages uninsured.

  • In 2014, nearly a quarter (23.4%) of all emergency department visits for adults aged 18 to 64 years were made by individuals with Medicaid, 15.1% were made by the uninsured, and 53.6% were by those with private coverage, reflecting the larger percentage of adults with private coverage, the report notes.

  • Personal healthcare expenditures in the United States in 2014 totaled $2.6 trillion, which was a 5.0% increase from 2013. Expenditures for hospital care made up 37.9% of all personal healthcare expenditures in 2014, whereas physician and clinical services accounted for 23.5% of total personal healthcare expenditures.

  • In 2014, prescription drug expenditures totaled $297.7 billion, up 12.2% from $265.3 billion in 2013.

  • In 2013, roughly eight of every 10 office-based physicians had computerized electronic health records capable of recording patient history and demographic information and ordering/submitting prescriptions to the pharmacy. About seven of 10 were able to order laboratory tests and provide electronic warnings of drug interactions and contraindications through electronic health records.

"Health, United States, 2015." CDC. Published April 27, 2016. Full text

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