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About Minority Health

The success or failure of any government in the final analysis must be measured by the well-being of its citizens. Nothing can be more important to a state than its public health; the state's paramount concern should be the health of its people.
                                                            ~ Franklin Delano Roosevelt

Life expectancy and overall health have improved in recent years for most Americans, thanks in part to an increased focus on preventive medicine and dynamic new advances in medical technology. However, not all Americans are benefiting equally. For too many racial and ethnic minorities in the United States, good health is elusive, since appropriate care is often associated with an individual's economic status, race, and gender.  While Americans as a group are healthier and living longer, the nation's health status will never be as good as it can be as long as there are segments of the population with poor health status.

Compelling evidence that race and ethnicity correlate with persistent, and often increasing, health disparities among U.S. populations demands national attention. Indeed, despite notable progress in the overall health of the Nation, there are continuing disparities in the burden of illness and death experienced by blacks or African Americans, Hispanics or Latinos, American Indians and Alaska Natives, and Native Hawaiian and Other Pacific Islanders, compared to the U.S. population as a whole. The demographic changes anticipated over the next decade magnify the importance of addressing disparities in health status. Groups currently experiencing poorer health status are expected to grow as a proportion of the total U.S. population; therefore, the future health of America as a whole will be influenced substantially by improving the health of these racial and ethnic minorities. A national focus on disparities in health status is particularly important as major changes unfold in the way in which health care is delivered and financed.

Current information about the biologic and genetic characteristics of minority populations does not explain the health disparities experienced by these groups compared with the white, non-Hispanic population in the United States. These disparities are believed to be the result of the complex interaction among genetic variations, environmental factors, and specific health behaviors.

red arrow Even though the Nation’s infant mortality rate is down, the infant death rate among African Americans is still more than double that of whites. Heart disease death rates are more than 40 percent higher for African Americans than for whites. The death rate for all cancers is 30 percent higher for African Americans than for whites; for prostate cancer, it is more than double that for whites. African American women have a higher death rate from breast cancer despite having a mammography screening rate that is nearly the same as the rate for white women. The death rate from HIV/AIDS for African Americans is more than seven times that for whites; the rate of homicide is six times that for whites.
red arrow Hispanics living in the United States are almost twice as likely to die from diabetes as are non-Hispanic whites. Although constituting only 11 percent of the total population in 1996, Hispanics accounted for 20 percent of the new cases of tuberculosis. Hispanics also have higher rates of high blood pressure and obesity than non-Hispanic whites. There are differences among Hispanic populations as well. For example, whereas the rate of low birth weight infants is lower for the total Hispanic population compared with that of whites, Puerto Ricans have a low birth weight rate that is 50 percent higher than the rate for whites.
red arrow American Indians and Alaska Natives have an infant death rate almost double that for whites. The rate of diabetes for this population group is more than twice that for whites. The Pima of Arizona have one of the highest rates of diabetes in the world. American Indians and Alaska Natives also have disproportionately high death rates from unintentional injuries and suicide.
red arrow Asians and Pacific Islanders, on average, have indicators of being one of the healthiest population groups in the United States. However, there is great diversity within this population group, and health disparities for some specific segments are quite marked. Women of Vietnamese origin, for example, suffer from cervical cancer at nearly five times the rate for white women. New cases of hepatitis and tuberculosis also are higher in Asians and Pacific Islanders living in the United States than in whites.
Source: Healthy People 2010.

The U.S. Department of Health and Human Services, (HHS) created the Office of Minority Health in 1985 as a result of the Report of the Secretary's Task Force on Black and Minority Health  which revealed large and persistent gaps in health status among Americans of different racial and ethnic groups. The Centers for Disease Control and Prevention (CDC) created its own Office of Minority Health (OMH) in 1988 in response to the same report. Congress passed the “Disadvantaged Minority Health Act of 1990” in order to improve the health status of underserved populations, including racial and ethnic minorities.

Healthy People 2010
The Healthy People Initiative has been the Nation's prevention and health promotion agenda for the last two decades. Healthy People 2010 is designed to achieve two overarching goals: 1) Increase quality and years of healthy life; 2) Eliminate health disparities. The CDC and the Agency for Toxic Substances and Disease Registry (CDC/ATSDR) has lead or co-lead responsibility for 18 of the 28 (64 percent) Healthy People 2010 focus areas, including all six areas identified in the HHS initiative to eliminate health disparities.

The second goal of Healthy People 2010 is to eliminate health disparities among different segments of the population 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. Healthy People is firmly dedicated to the principle that regardless of differences among populations every person in every community across the Nation deserves equal access to comprehensive, culturally competent, community-based health care systems that are committed to serving the needs of the individual and promoting community health.

Healthy People 2010 identifies 10 Leading Health Indicators (LHIs) that are major public health concerns in the United States.  They represent opportunities for individuals and communities to take action to realize significant health improvements and prevent future health concerns. The LHIs were chosen because they are "determinants of health." As determinants of health, the LHIs are critical influences that precede a wide variety of health problems. They also may affect the course of existing disease. The LHIs were chosen based on their ability to motivate action, the availability of data to measure their progress, and their relevance as broad public health issues. The LHIs are intended to help everyone more easily understand the importance of health promotion and disease prevention and to encourage wide participation in improving health in the next decade. Developing strategies and action plans to address one or more of these indicators can have a profound effect on increasing the quality of life and the years of healthy life and on eliminating health disparities -- creating healthy people in healthy communities.

Healthy People 2010 Leading Health Indicators

  1. Physical activity
  2. Overweight and Obesity
  3. Tobacco use
  4. Substance abuse
  5. Responsible sexual behavior
  6. Mental health
  7. Injury and violence
  8. Environmental quality
  9. Immunization
  10. Access to health care
Source: Healthy People 2010.

REACH 2010
Racial and Ethnic Approaches to Community Health (REACH) 2010
is a cornerstone of CDC’s efforts to eliminate racial and ethnic disparities in health. Launched in 1999, REACH 2010 is designed to eliminate disparities in six priority areas in which racial and ethnic minorities experience serious disparities in health access and outcomes. 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.

  1. Infant Mortality
  2. Deficits in Breast & Cervical Cancer Screening & Management
  3. Cardiovascular Diseases
  4. Diabetes
  5. HIV Infections/AIDS
  6. Child and Adult Immunizations
Source: Reach 2010.

Leading Causes of Death
CDC/ATSDR's National Center for Health Statistics (NCHS) is the Nation's principal health statistics agency. NCHS compiles statistical information to guide actions and policies to improve the health of the Nation's people. NCHS' health statistics document the health status of the population and of important subgroups; identify disparities in health status and use of health care by race, ethnicity, SES, region, and other population gradients; describe people's experiences with the health care system; monitor trends in health status and health care delivery; identify health problems; support biomedical and health services research; provide information for making changes in public policies and programs; and evaluate the impact of health policies and programs.

The leading causes of death are frequently used to describe the health status of the Nation. The Nation has seen a great deal of change over the past 100 years in the leading causes of death. At the beginning of the 1900s, infectious disease ran rampant in the United States and worldwide and topped the leading causes of death. A century later, with the control of many infectious agents and the increasing age of the population, chronic diseases top the list.

A very different picture emerges when the leading causes of death are viewed for various subgroups. Unintentional injuries, mainly motor vehicle crashes, are the fifth leading cause of death for the total population,1 but they are the leading cause of death for people aged 1 to 44 years.2 Similarly, HIV/AIDS is the 14th leading cause of death for the total population3 but the leading cause of death for African American men aged 35 to 44 years.4

According to NCHS, the following are the ten leading causes of death in the U.S. in 2001 for all Americans:

1. Heart disease
2. Cancer
3. Stroke
4. Chronic lower respiratory disease
5. Unintentional injuries
6. Diabetes
7. Influenza and Pneumonia
8. Alzheimer's disease
9. Nephritis, Nephrotic syndrome, and Nephrosis
10. Septicemia

Source: Health, U.S., 2003, Table 31.


1 National Center for Health Statistics (NCHS), 2000.
2 NCHS, Health, United States, 2002, Table 33.
3 NCHS, 2000.
4 National Center for HIV, STD, and TB Prevention (NCHSTP), 2002.


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Last Updated on November 03, 2004
Office of Minority Health

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