Minority health addresses the special medical and health needs associated
with specific ethnic and other minority groups.
The United States, along with many other countries, experiences cultural
diversity. This fact poses health issues that are specific to ethnic and
other minority groups. Additionally, the propensity for certain diseases
or illnesses is of concern in certain minority groups. These specific
health issues include
, cardiovascular disease, diabetes,
, and immunizations. The primary minority groups in the United States are
Hispanics, African Americans, Native Americans and Native Alaskans, Native
Hawaiians and other Pacific Islanders, and gays and lesbians.
One of the major health problems in the United States is overweight and
, which lead to increased risks for a wide variety of conditions,
including cardiovascular disease, diabetes,
, and cancer. A 2003 study by the Agency for Healthcare Research and
Quality shows that African-American and Hispanic children face much higher
odds of being overweight than non-Hispanic white or Asian-American and
Pacific Islander children. African-American children ages six to 11 are
more than twice as likely as non-Hispanic white children to be overweight,
and Hispanic children are roughly twice as likely. The odds change
dramatically when children become teenagers. For example, as children,
Asian Americans and Pacific Islanders have the lowest prevalence of being
overweight, but once they reach
, the reverse is true. As teens, they have the highest prevalence of being
overweight—more than four times that of non-Hispanic white
teenagers. African American children have the highest rate of being
overweight, but once they reach their teen years, they are no more likely
than white children to be overweight. Hispanic teens are one-and-a-half
times more likely than white or African American teens to be overweight.
Researchers and policymakers have attributed the poorer health of minority
Americans in part to their reduced access to medical care and the lower
quality of primary care they receive. Indeed, when asked about the primary
care they receive, minority patients—particularly Asian
Americans—give the primary care they receive lower marks than white
patients do, according to a 2001 report by the Agency for Healthcare
Research and Quality. After adjustment for socioeconomic and other
factors, Asian Americans gave their primary care significantly lower
scores (out of 100 total) than whites for communication (69 versus 79) and
comprehensive knowledge of patients (48 versus 56), as well as all other
areas of primary care except continuity of care and integration of care.
African American and Hispanics reported significantly less financial
access to care than whites (60 and 56, respectively, versus 65), and
African Americans reported significantly less continuity of care than
whites (74 versus 78), but their assessments of other aspects of primary
care did not differ significantly from whites. This study agrees with
others which show that Asian Americans tend to be the least satisfied with
quality of care. However, this study was limited by the small number of
Asian and Hispanic patients surveyed, as well as the lack of
patient's country of origin and physician's ethnicity,
factors that may affect patient evaluations of primary care.
Infant mortality rates (IMRs) in the United States and in all countries
worldwide are an accurate indicator of health status. They provide
information concerning programs about pregnancy education and counseling,
technological advances, and procedures and aftercare. IMRs vary among
racial groups. Infant mortality among African Americans in 2000 occurred
at a rate of 14.1 deaths per 1,000 live births. This is more than twice
the national average of 6.9 deaths per 1,000 live births. The leading
causes of infant death include congenital abnormalities, pre-term/low
sudden infant death syndrome
(SIDS), problems related to complications of pregnancy, and
respiratory distress syndrome
. SIDS deaths among Native American and Alaska Natives is 2.3 times the
rate for non-Hispanic white mothers.
Cancer is a serious national, worldwide, and minority health concern. It
is the second cause of death in the United States, claiming over 500,000
lives each year. Approximately 50 percent of persons who develop cancer
die of the disease. There is great disparity among the cancer rates in
minority groups. Across genders, cancer death rates for African Americans
are 35 percent higher when compared to statistics for Caucasians. The
death rates for prostate cancer (two times more) and lung cancer (27 times
more) are disproportionately higher when compared to Caucasians. There are
also gender differences among ethnic groups and specific cancers. Lung
cancers in African American and Hawaiian men are evaluated compared with
Caucasian males. Vietnamese females who live in the United States have
five times more new cases of cervical cancer when compared to Caucasian
women. Hispanic females also have a greater incidence of cervical cancer
than Caucasian females. Additionally, Alaskan native men and women have a
greater propensity for cancers in the rectum and colon than do Caucasians.
Cardiovascular disease is the leading cause of disability and death, about
equal to the rate of death from all other diseases combined.
Cardiovascular disease can affect the patient's lifestyle and
function in addition to having an impact on
members. The financial costs are very high. Among ethnic and racial
groups cardiovascular disease is the leading cause of death.
is the leading cause of cardiovascular-related death, which occurs in
higher numbers for Asian-American males when compared to Caucasian men.
Mexican-American men and women and African-American males have a higher
incidence of hypertension. African American women have higher rates of
being overweight, which is a major risk factor of cardiovascular disease.
African Americans are 13 percent less likely to undergo coronary
angioplasty and one-third less likely to undergo bypass surgery than are
Diabetes, a serious health problem among Americans and ethnic groups, is
the seventh leading cause of death in the United States. The prevalence of
diabetes in African Americans is about 70 percent higher than Caucasians.
The burden of diabetes is much greater for minority populations than the
white population. For example, 10.8 percent of non-Hispanic blacks, 10.6
percent of Hispanics, and 9 percent of Native Americans and Native
Alaskans have diabetes, compared with 6.2 percent of whites. Certain
minorities also have much higher rates of diabetes-related complications
and death, in some instances by as much as 50 percent more than the total
population. Diabetes-related mortality rates for African Americans,
Hispanic Americans, and Native Americans and Native Alaskans are higher
than those for white people. Asians and Pacific Islanders have the lowest
diabetes-related mortality of any racial/ethnic group in the United
HIV infection/AIDS is the most common cause of death for all persons age
25 to 44 years old. Ethnic groups account for 25 percent of the U.S.
population and 54 percent of all
cases. In addition to sexual transmission there is an increase in HIV
among ethnic groups related to intravenous drug usage. African Americans
with HIV infection are less likely to be on antiretroviral therapy, less
likely to receive prophylaxis for Pneumocystis
, and less likely to be receiving protease inhibitors than other persons
with HIV. An HIV infection data coordinating center, under development in
2004, will allow researchers to compare contemporary data on HIV care to
determine whether disparities in care among groups are being addressed and
to identify any new patterns in treatment that arise. Among children, the
disparities are dramatic, with African-American and Hispanic children
representing more than 80 percent of pediatric AIDS cases in 2000.
Approximately 78 percent of HIV-infected women are minorities and most
become infected through heterosexual transmission.
In 2002, African Americans accounted for 50 percent of all new AIDS cases,
while Hispanics accounted for 20 percent, according to the Centers for
Control and Prevention (CDC). Although the virus is still most likely to
be passed on by gay and bisexual males, as of 2004 more than 25 percent of
AIDS cases are women, most of whom are African American or Hispanic.
According to the National Center for Health Statistics, black females age
15 and older are 15.5 times more likely to die of AIDS than
whites—a figure even more dramatic than the one presented in the
vice presidential debates, according to an article in the October 16, 2004
Los Angeles Times
Data show that in 2000 children living below the poverty level have lower
immunization coverage rates. Although significant progress has been made
in improving childhood immunization rates, some disparities in overall
immunization coverage rates among racial and ethnic groups continue. This
disparity is of great concern in large urban areas with underserved
populations because of the potential for outbreaks of vaccine-preventable
The overall health of the U.S. population improved during the last decades
of the twentieth century, but all Americans have not shared equally in
these improvements. Among nonelderly adults, for example, 17 percent of
Hispanic and 16 percent of black Americans report they are in minimally
fair or poor health, compared with 10 percent of white Americans.
Causes and symptoms
Most IMRs are correlated with prenatal care. Women who receive adequate
prenatal care tend to have better pregnancy outcomes when compared to
those who receive little or no care. Women who receive inadequate prenatal
care tend to have increased chances of delivering a very low birth weight
(VLBW) infant, which is linked to risk of early death.
Cancer is related to several preventable lifestyle choices. Diet and
tobacco and sun exposure can be shaped by lifestyle modifications.
Additionally many cancers can occur due to lack of interest in and/or lack
of availability for screening and educational programs.
Cardiovascular diseases are higher among persons with high blood
cholesterol and high blood pressure. Certain lifestyle choices that may
increase the chance for heart disease include lack of
, overweight, and cigarette use. Cardiovascular disease is responsible for
over 50 percent of the deaths in persons with diabetes.
HIV occurs at a higher frequency among gay males (the number of
African-American males who have AIDS through sex with men has as of 2004
increased). Additionally unprotected sexual intercourse and sharing used
needles for IV drug injection are strongly correlated with infection.
Vaccinations are an effective method of preventing certain disease such as
, and pneumococcal infections. Approximately 90 percent of
influenza-related mortality is associated with persons aged 65 and older.
This is mostly due to neglect of vaccinations. About 45,000 adults each
year die of diseases related to hepatitis B, pneumococcal and influenza
Parents of minority children should contact their family physician or
other healthcare provider when they have any concern about their
The diagnosis of VLBW occurs when newborns are weighed. Infants who weigh
52.5 ounces (1,500 grams) are at high risk for death. For cancer, the
diagnosis can be made through screening procedures such as mammography
(for breast cancer), PAP smear (for cervical cancer). Lifestyle
modifications such as avoidance of sun, cessation of cigarette
, maintaining a balanced diet, and adequate
, all positively affect one's health. Other specific screening
tests (PSA, prostate surface antigen) are helpful for diagnosing prostate
cancer. Cardiovascular diseases can be detected by medical check-up. Blood
pressure and cholesterol levels can be measured. Obesity can be diagnosed
by assessing a person's weight compared to the person's
height. Diabetes and its complications can be detected by blood tests,
indepth eye examinations, and studies that assess the flow of blood
through blood vessels in the legs. HIV can be detected through a careful
history and physical examination and analysis of blood using a special
test called a western blot. Infections caused by lack of immunizations can
either be detected by conducting physical examination and culturing the
specific microorganism in the laboratory.
Treatment should be directed toward the primary causes(s) that minorities
have increased chances of developing disease(s). Cancer may require
treatment using surgery, radiotherapy, or
. Cardiovascular diseases may require surgical procedures for
establishing a diagnosis and initiating treatment. Depending on the
extent of disease, cardiovascular management can become complicated
requiring medications and daily lifestyle modifications. Treatment usually
includes medications, dietary modifications, and—if complications
arise—specific interventions tailored to alleviating the problem.
HIV can be treated with specific medications and more often than not with
symptomatic treatment as complications arise. Diseases caused by lack of
immunizations are treated based on the primary disease. The best method of
treatment is through prevention and generating public awareness through
widespread education on the topic.
Alternative therapies do exist, but as of 2004 more research is needed to
substantiate available data. Most physicians say the diseases that relate
to minority health are best treated with nationally accepted standards of
Generally the prognosis is related to the diagnosis, patients'
state of health, age, and the presence of another disease or complication
in addition to the presenting problem. The course for IMRs is related to
educational programs and prenatal care, which includes medical and
psychological treatments. The prognosis for chronic diseases such as
cardiovascular problems, high blood pressure, cancer, and diabetes is
variable. As of 2004, these diseases are not cured, and control is
achieved by standardized treatment options. Eventually complications,
despite treatment, can occur. For HIV the clinical course as of 2004 is
death, even though this process may take years. Educational programs with
an emphasis on disease prevention can potentially improve outcomes
concerning pediatric and geriatric diseases.
Prevention is accomplished best through educational programs specific to
target populations. IMRs can be prevented by increasing awareness,
interest, and accessibility for prenatal care that offers a comprehensive
approach for the needs of each patient. Regular physicals and special
screening tests can potentially prevent certain cancers in high-risk
groups. Educational programs concerning lifestyle modifications, diet,
exercise, and testing may prevent the development of cardiovascular
disease and diabetes. Educational programs for illicit IV drug abusers and
persons who engage in unprotected sexual intercourse may decrease the
incidence of HIV infection.
All children should have regular well-child check ups according to the
schedule recommended by their physician or pediatrician. The American
Academy of Pediatrics (AAP) advises that children be seen for well-baby
check ups at two weeks, two months, four months, six months, nine months,
12 months, 15 months, and 18 months of age. Well-child visits are
recommended at ages two, three, four, five, six, eight, ten, and annually
thereafter through age 21. Parents can take some precautions to ensure the
health of their children.
the home, following a recommended immunization schedule, educating kids
(CPR), and taking kids for regular well-child check-ups all help to
protect against physical harm. In addition, encouraging open communication
with children can help them grow both emotionally and socially. Providing
a loving and supportive home environment can help to nurture an
emotionally healthy child who is independent, self-confident, socially
skilled, insightful, and empathetic towards others.
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