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chapter 10

Terms in this set (21)

U.S. population
Majority - white, non-Hispanic (66%)
Racial or ethnic minorities (34%)
Racial and Ethnic Classifications
Classifications used to operationalize race and ethnicity.
Challenges with classifications representing diversity of population.
Categories of race are more social than biological.
Self-reported data can be unreliable.
Many nonfederal systems do not collect racial and ethnic data.
Health Data Sources and Their Limitations
Challenges in complete and accurate collection of racial and ethnic data
Bias analysis
HHS has long-term strategy for improving collection and use of racial and ethnic data
Important to understand health beliefs of various groups
--Heterogeneity within groups
Americans of Hispanic Origin
Hispanic origin is an ethnicity, not a race
Persons of Mexican, Puerto Rican, Cuban, Central American, or South American descent, or some other Spanish origin
Nearly all Hispanics (96%) in the U.S. are classified by race as white
Educational attainment
Income
Health beliefs
Black Americans
Black or African Americans
--People having origins in any of the black racial groups from Africa
More than ½ live in southern regions of U.S.
Educational attainment
Income
Health beliefs and culture
Asian Americans and Pacific Islanders
Now two separate racial groups
Generally concentrated in the western states
Educational attainment
Income
Health beliefs
-Variations among the many groups
--Generational differences
American Indians and Alaska Natives
Original inhabitants of America
Economically and socially disadvantaged
--Relatively poor health status
Education
Income
Health beliefs
--Various tribal groups have distinct customs, languages, and beliefs
---Many share the same cultural values
Native Americans and Health Care
Many tribes are sovereign nations
--Tribes transferred land in U.S. to federal government in return for provision of certain services
Indian Health Services (IHS) within HHS
--Responsible for federal health services to Native Americans and Alaska Natives
--Goal to raise health status to highest possible level
Refugees
Refugees
Immigrants
Aliens
Illegal aliens
Can be classified into existing racial/ethnic groups; as a single group, present special concerns
Education, health problems, injuries, employment, etc.
Race and Health Initiative
Goal to eliminate disparities among racial and ethnic minority populations in six areas of health while maintaining progress of overall health of American people
-Infant mortality
-Cancer screening and management
-Cardiovascular disease
-Diabetes
-HIV/AIDS
-Adult and child immunization
Infant Mortality
Serious disparity in U.S. among racial and ethnic minorities
-Black Americans infant death rate more than two times that of white Americans
--Lack of prenatal care and low-birth-weight babies
Cancer Screening and Management
Incidence and death rates highest among black Americans for various types of cancer
Many disparities attributed to lifestyle factors, late diagnosis, access to health care
Less primary and secondary prevention in various minority groups
Cardiovascular Diseases
Death rates vary widely among racial and ethnic groups
Black Americans have higher rates from CHD and stroke
Hypertension prevalence as a risk factor varies according to race/ethnicity
Black American tend to develop hypertension earlier in life than whites; unknown reason
Diabetes
Overall prevalence has risen in U.S. in recent years
Prevalence in those 20 and older varies in minority groups
Increase in age-adjusted death rates in all racial and ethnic groups
Significantly higher in minority groups
HIV Infection/AIDS
Proportional distribution of AIDS cases has increased in black Americans and Hispanics and decreased in white Americans
Attributed to higher prevalence of unsafe or risky health behaviors, and lack of access to health care to provide early diagnosis and treatment
Child and Adult Immunization Rates
Early childhood immunizations do not vary significantly by race or ethnicity
Older adult immunization rates are substantially lower in minority groups, even though an overall increase has occurred
Socioeconomic Status and Racial and Ethnic Disparities in Health
Many factors contribute to health disparities - economic, educational, behavioral, cultural, legal, and political
Socioeconomic status (SES) considered the most influential single contributor to premature morbidity and mortality
Association between SES and race/ethnicity is complicated and cannot fully explain all disparity
Equity in Minority Health
Simple solutions unlikely
Solutions to problems for one group may not work for another
Solutions must be culturally sensitive
Cultural Competence
A set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals, that enables effective work in cross-cultural situations
Culture is vital in how community health professionals deliver services and how community members respond to programs and interventions
Empowering the Self and the Community
To enable people to solve their community health problems
Three kinds of power associated with empowerment
Social - access to "bases"; needed to gain political power
Political - power of voice and collective action
Psychological - individual sense of potency
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