Overview: There are continuing disparities in the burden of illness and death experienced by African Americans, Hispanic Americans, Asian Americans/Pacific Islanders, and American Indians/Alaska Natives, as compared to the U.S. population as a whole. Statistical reviews of the disproportionate toll of certain diseases on racial and ethnic populations highlights the need for prevention, treatment and resources toward reducing the loss of life. Here is an overview of health disparities in six key areas.
Overall, African Americans are more likely to develop cancer than persons of any other racial or ethnic group, and have the highest cancer death rate than any other racial or ethnic group. The prostate cancer incidence rate among African American men is 60 percent higher than the rate in White men and the prostate cancer death rate is more than twice as high among African Americans than any other racial or ethnic group. Although the rate of newly diagnosed cases of breast cancer is about 13 percent lower than in White women, African American women have higher mortality rates than any other racial or ethnic group. For Hispanic women, the incidence of cervical cancer is two and half times higher than the rate of White women. Asian American/Pacific Islanders and American Indians have higher rates of stomach cancer than Whites, and cervical cancer incidence rates are highest among Hispanic and Vietnamese American women than White women.
Cardiovascular Disease and Stroke
Heart disease is the leading killer across most racial and ethnic minority communities in the United States, accounting for around one quarter of all deaths in 2001.
African Americans suffer the most from the disease. Around 40 percent of African American men and women have some form of heart disease, compared to 30 percent of White men and 24 percent of White women. African Americans are also 29 percent more likely to die from the disease than Whites.
While Hispanics die from heart disease at a lesser rate than Whites, Mexican American women are diagnosed with the condition more frequently than White females. Mexican Americans, who make up the largest share of the U.S. Hispanic population, also suffer in greater numbers from overweight and obesity than Whites, two of the leading risk factors for heart disease. More than 25 percent of deaths in the Asian and Pacific Islander community and 20 percent of deaths in the American Indian community are caused by heart disease.
Stroke is the third leading cause of death in the United States. Each year about 700,000 people experience a stroke. On average, every 45 seconds someone in the United States has a stroke, and every three minutes someone dies of a stroke. Stroke death rates are substantially higher for African Americans than for Whites.
More than 20.8 million adults have diabetes in the United States, and pre-diabetes is far more common than previously believed. About 40 percent of U.S. adults ages 40 to 74--or 41 million people--currently have pre-diabetes. Racial and ethnic minority groups, especially the elderly among these populations, are disproportionately affected by diabetes.
In women, overweight and obesity, a major risk factor for diabetes, are higher among members of racial and ethnic minority populations than in White women, with more than half of all African American women ages 20-74 obese. In men, Mexican Americans have a higher prevalence of overweight and obesity than non-Hispanic men, while White men have a greater prevalence than African American men. Approximately 300,000 U.S. deaths a year currently are associated with obesity and overweight.
African Americans are twice as likely to have diabetes as Whites. The highest incidence of diabetes in African Americans occurs between 65-75 years of age. African American women are especially affected, with nearly 12 percent of African American women over 20 years of age having diabetes, in comparison to 8.5 percent of men in the same age group. African Americans with diabetes are more likely to experience complications of diabetes. Diabetic retinopathy, an eye disease, is 40 to 50 percent more common in African Americans than Whites. Kidney failure (end-stage renal disease or ESRD) is about 4 times more common in African Americans with diabetes than in Whites with diabetes. Amputations of lower extremities (legs and feet) are also more common in African Americans with diabetes.
As of 2002, two million Hispanic adults, about 8.2 percent of the population, have diabetes. Diabetes is more prevalent in older Hispanics, with about 25 to 30 percent of Hispanics age 50 or over having the disease. About one-third of Hispanics with diabetes are undiagnosed. Hispanics are 1.5 times as likely to have diabetes as Whites. And, in 2001 the death rate from diabetes in Hispanics was 40 percent higher than the death rate of Whites.
The incidence of diabetes among American Indians and Alaska Natives is more than twice that of Whites. As of 2003, 14.5 percent of the American Indian and Alaska Natives served by the Indian Health Service had been diagnosed with diabetes. The likelihood of having diabetes is higher in older age groups, with about 20 percent of American Indians and Alaska Natives between 45 and 64 having diabetes, and about 23 percent of American Indians and Alaska Natives over age 64 having diabetes.
Diabetes is the fifth leading cause of death in the Asian American and Pacific Islander population. Prevalence data for diabetes among this group are limited, but some subpopulations are at increased risk for diabetes. Native Hawaiians, Japanese and Filipino adults living in Hawaii were about two times more likely to have been diagnosed with diabetes as compared to White residents.
HIV/AIDS has had a devastating impact on minorities in the United States. Racial and ethnic minorities accounted for almost 70 percent of the newly diagnosed cases of HIV and AIDS in 2002. More than 90 percent of babies born with HIV belong to minority groups.
In the African American community, HIV/AIDS has become an epidemic. More than 54 percent (14,398) of HIV/AIDS diagnoses in 2002 were in African Americans. African Americans are ten times more likely to die of AIDS than Whites. AIDS is the leading cause of death in African American women aged 25-34 and the third leading cause of death in African American men in the same age group. More than 64 percent of HIV positive infants are African American. HIV/AIDS is spreading at a rapid rate in the Hispanic community. Hispanics accounted for around 20 percent of AIDS cases in 2002, despite making up only 14 percent of the U.S. population. Hispanics are 60 percent more likely to be diagnosed with AIDS than Whites. Hispanics were also almost three times more likely to die of AIDS than their White counterparts in 2001. Though the numbers are small, American Indians are also impacted disproportionately by HIV/AIDS. American Indians are three times more likely to have AIDS than Whites.
For Asians and Pacific Islanders, HIV/AIDS is the sixth leading cause of death in men aged 25 to 34 and the 24th leading cause of death overall.
In 2003, 69 percent of older White persons received influenza vaccination, compared to only 49 percent and 47 percent of older African American and Hispanic persons, respectively. Disparities for pneumococcal vaccination coverage were even wider. Vaccination rates were nearly 60 percent for Whites, compared to 37 percent for African Americans and 31 percent for Hispanics.
The United States has made substantial improvements in infant mortality, but disparities still exist. In 2001, the infant mortality rate for African American infants more than twice the rate for White infants (13.3 deaths per 1,000 for African Americans vs. 5.7 for Whites). In American Indian and Alaska Native populations, the death rate is 70 percent higher than in Whites. Although the infant death rate for Hispanic infants is less than the rate for White infants, within the Puerto Rican subgroup, the rate of infant deaths from Sudden Infant Death Syndrome (SIDS) is 1.5 times higher than Whites. SIDS rate for African Americans was 2.2 times that for Whites.