Racial diversity matters in public health
Friday, July 22, 2016
Every day, our nation is becoming more diverse — in classrooms, workplaces, neighborhoods and communities.
According to a 2010 study from the United States Census Bureau, "The Two or More Races Population: 2010," the number of biracial Americans (reporting themselves as both black and white) grew by more than 1 million people between 2000 and 2010, a 134 percent increase. Similarly, people who reported their race as both white and Asian grew by about three-quarters of a million people, an 87 percent increase.
A 2015 Pew Research Center article, "Multiracial in America, Proud, Diverse and Growing in Numbers" described a survey that said 60 percent of multiracial adults were proud of their mixed-race background, while 59 percent felt their racial heritage made them more open to other cultures.
Overall, biracial adults who are both white and black are three times as likely to say they have a lot in common with people who are black than they do with whites (58 vs. 19 percent). On the other hand, biracial adults who are white and Asian said they have more in common with whites than they do with Asians (60 vs. 33 percent).
The health of all racial and ethnic groups is key to our public health. Unfortunately, racial and socioeconomic disparities still exist. For example, the Centers for Disease Control and Prevention (CDC) found the life expectancy between black Americans and white Americans varies significantly. On average, black Americans die 3.8 years before white Americans due to higher rates of heart disease, cancer, homicide, diabetes and perinatal conditions.
How health disparities affect segments of population
Healthy People 2020 defined a health disparity as "a particular type of health difference that is closely linked with social, economic and/or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion."
Health disparities are evident in the United States. The health of black women affects their babies and places these mothers at a higher risk for pregnancy and birth complications. According to the U.S. Department of Health and Human Services, the Office of Minority Health, the infant mortality rate among black infants is 2.2 times higher than that of white infants. Black infants are 3.5 times as likely to die as infants due to complications related to low birth weight as compared to white infants.
Racial disparities in health exist for the onset of the disease, as well as for the severity and the progression of disease. While it is well known that for white women, the incidence of breast cancer is higher than that of blacks; African-American women are more likely to get breast cancer when they're under 40, as compared to white women. Also, black women are more likely to be diagnosed with breast cancer with late and aggressive stages with a poor outcome, compared to white women.
Socioeconomic status (SES) is a key determinant of racial disparities in health. Researchers found blacks had higher blood pressure and inflammation even after adjustment for income, education, gender and age. Blacks maintained high-risk profiles even after adjusting for health behaviors (smoking, poor diet, physical activity and access to care).
Access to and coverage of medical care is another social disparity in health in the U.S. In 2009, blacks under age 65 were less likely than whites to have health insurance (81 percent compared with 83 percent).
What we should do to resolve health disparities
Public health agencies at the state and community levels should play an important role in providing key resources regarding health insurance availability and insurance coverage. The Office of Disease Prevention and Health Promotion offers the Healthy People 2020 website, and the American Public Health Association (APHA) created a series of webinars about racism's impact on public health.
Healthcare disparities remain a crucial issue in the United States. It is the public health professionals' duty to address the racial and ethnic disparities in health, identify the determinants of disparities, and document various risk factors and environmental exposure among different ethnic groups. Our focus should always be to eliminate disparities (in healthcare access and health outcomes) and achieve health equity for all mankind, regardless of their skin color or the language they speak.
"Whether we like it or not, we have all been born on this earth as part of one great human family. Rich or poor, educated or uneducated, belonging to one nation or another, to one religion or another, adhering to this ideology or that, ultimately each of us is just a human being like everyone else: We all desire happiness and do not want suffering. Furthermore, each of us has an equal right to pursue these goals." — Dalai Lama
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