Health Disparities

Outline:
 What are Health Disparities

 Causes of Health Disparities

 Rates of Health Disparities

- African Americans
- Disparities in Medical Diagnosis and Treatment
- Hispanics and Latinos
- Asian Americans & Pacific Islanders

 Efforts to reduce Disparities in Health

 Public & Private Investment to Eliminate Health Disparities

 What are Health Disparities?

 World Health Organization (WHO)

 National Institute of Health (NIH)

 Dr. Martin Luther King

Causes of Health disparities:

 Methodological Differences
• Data Collection

 Socioeconomic Differences
• Health services access
• Education & Behaviors
• Working Environment

 Biological Differences
• Anatomical/Physiologic
• Genetic
Causes of Health disparities:

 Sociocultural Differences
• Patient health related behavior
- Diet
- Substance use
- Occupation
- Leisure activity
 Professional Competency
• Patient Explanatory Models
 Rates of Health Disparities:

• Rate of suicide in adolescents has tripled in the last 30 years

• In San Diego compared to national data, higher percentage of youth report
suicide attempts in the last 12 months (YRBS 2003)
• Gay adolescents are 2-3 times more likely than peers to attempt suicide
• Self-identified GLB youth are at increased risk for mental and physical health
problems (Lock J 1999)
• Women are at greater risk for Alzheimer disease than men and are twice as
likely as men to be affected by major depression
 Rates of Health Disparities cont. :

• The Appalachian region suffers an excess in premature deaths (among persons

ages 35 to 64) from heart disease, all cancers combined, lung cancer,
colorectal cancer, chronic obstructive pulmonary disease, diabetes, and motor
vehicle accidents, relative to comparable non-Appalachian U.S. population.
 African Americans
• Experience a more than double infant mortality rate

• Have a 30% higher death rate for all cancers

• Are more than seven times more likely to die from HIV/AIDS

• Are five times more likely to develop the most common type of glaucoma and

are six times more likely to become blind from glaucoma

 Disparities in Medical Diagnosis and Treatment

• Hispanic patients with long bone fractures are twice as likely as non-Hispanic
whites to receive no ED pain medication (Todd et al., 1993).
• Black patients with long bone fractures are 1.66 times as likely as non-Hispanic
white patients to receive no ED pain medication (Todd et al., 2000).
• Blacks are less likely to be referred for cardiac catheterization than whites,
despite identical clinical presentations and lab/EKG data (Shulman et al., 1999).
• Minorities less likely to be screened for cholesterol levels (Naumburg et al.,
1993).
 Hispanics and Latinos

• Are almost twice as likely to die from diabetes

• Accounted for 20% of new cases of TB, despite only comprising 11% of the

population in 1996

• Have higher rates of high blood pressure and obesity

 Asian Americans & Pacific Islanders

• Have higher rates of new cases of hepatitis and tuberculosis

• Demonstrate signs of being a healthy population, on average, but exhibit great

diversity within the population. For example, Vietnamese women suffer from

cervical cancer at nearly five times the rate of Caucasian women

 Efforts to Reduce Disparities in Health

 National Institutes of Health (NIH)

• New Institute created at NIH: National Institute on

Minority Health and Health Disparities (NCMHD)
 Efforts to Reduce Disparities in Health

 San Diego EXPORT Center

Excellence in Partnerships for Community Outreach,

Research on Disparities in Health and Training

OF
REHDI
COUNCIL
COMMUNITY CLINICS County of San Diego, HHSA
 Efforts to Reduce Disparities in Health

 University of California’s PRIME

PRIME – Program in Medical Education

 UCSD’s PRIME-HEq
USSD’s PRIME Health Equity
Public & Private Investment to Eliminate Health Disparities
 Thank You!!
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