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HEALTH DISPARITIES IN THE UNITED STATES

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The Children’s Defense Fund (2003) has identified disparities in health for poor and minority children, especially black and Latino children. They continue to lag behind white and affluent children in almost every health indicator. Most of the current research is focused upon eliminating health disparities in health care for adults. Research on children indicates “that disparities persist in the areas of infant mortality, immunizations, asthma, dental care, lead poisoning, and obesity, to name a few of the conditions that affect children” (p. 2). These conditions can affect children’s development and functioning before birth, in adolescence, and over the course of a lifetime.

Socioeconomic status is a strong determinant of health outcomes because it affects access to insurance and health services. The population groups with the worst health status are those with the highest poverty rates and the least education. As pointed out earlier, racial minorities do not compare well with whites on a variety of socioeconomic indicators that are the strongest predictors of health. In addition to the aforementioned indicators, minorities have fewer employment opportunities. Black and Hispanic unemployment rates are much higher (sometimes over two times higher than whites) (CDF 2003, p. 3). As a result, minorities are less likely to have employer-sponsored health insurance and are more likely to be uninsured. The health coverage a person has governs how quickly the person will get health care and whether it is the best care available. Blacks are almost twice as likely and Latinos almost three times as likely to be uninsured as whites. A 2005 study (Lillie-Blanton and Hoffman) shows that these disparities would be significantly reduced if black and Latinos were insured at levels comparable to those of whites.

According to CDF (2003), there is a growing body of published research that indicates that racial and ethnic minority patients receive a lesser amount of care and a lower quality of care for the same illness, even when they are at the same income level and insurance coverage level as white patients.

Infant Mortality and Prenatal Care . One of the most important indicators of children’s health is infant mortality and birth weight rates in different populations. Although overall infant mortality rates dropped as of 2002, the gap between the white and black infant mortality rate has not narrowed. According to Matthews, et al. (2004), in 2002 there were more than 28,000 infant deaths in the United States, more than all the deaths among children between the ages of one and nineteen. Black infants were more than twice as likely to die as white infants.

Low birth weight is the leading cause of infant mortality among all races. It is the greatest cause of death for black infants. According to Martin, et al. (2003), non-Latino black infants were almost twice as likely to be born at low birth weight as were non-Latino white infants (13.4% versus 6.9%).

The most critical component of reducing the incidence of infant mortality and low birth weight is prenatal care for pregnant women. The level and timing of such care is used as a proxy for access to care and birth outcomes. There are racial and ethnic differences in the timeliness of prenatal care. In 2002, 75.2 percent of non-Latino black and 76.7 percent of Latino women received prenatal care in the first trimester, compared to 85.4 percent of non-Latino white women (Martin, et al. 2003). Non-Latino black and Latino women were more than twice as likely as nonLatino white women to have late or no prenatal care (6.2% and 5.5% respectively, versus 3.1%).

Hunger . The U.S. Department of Agriculture (USDA) defines “food security” as having access to enough food for active healthy living (Nord, Andrews, and Carlson 2003). Families without enough food are often referred to as “food insecure” households. Most food insecure households avoid hunger by limiting the types of food they buy and relying on public assistance food programs. However, in about one-third of food insecure households, one or more household members are hungry at some time.

Children who are hungry and food insecure are at greater risk for deficits in cognitive development and academic achievement. According to the USDA, in 2003, 28.5 percent of African American and 28.1 percent of Hispanic households with children experienced food insecurity, compared with 11.3 pernt of white households.

Healy, Michael(1983–1904) - Naval officer, Begins Seafaring Career, Chronology, Becomes King of the Arctic and Bering Seas [next] [back] Healing of the Paralytic

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