Page 240 - Encyclopedia of Nursing Research

HeAlTH DISpArITIeS IN rAcIAl AND eTHNIc MINOrITIeS n 207

other health conditions that exist among spe- Since that time, there have been numer-
cific population groups in the United States ous national policy initiatives to address
(Keppel et al., 2005). Health disparities have health disparities. Healthy people 2000, for H
been discussed in relation to health care example, called for a reduction in health dis-
access and quality, health status, burden of parities, whereas Healthy people 2010 set as
disease, and excess deaths (carter-pokras a national priority the elimination of health
& Baquet, 2002). Health disparities in the disparities among segments of the popula-
United States have been associated with age, tion that occur by gender, race or ethnicity,
gender, income, educational level, sexual ori- education or income, disability, geographic
entation, disability, geographic location, and location, or sexual orientation (U.S. DHHS,
racial and ethnic minority status. Similarly, 2000). currently, the proposed objectives
inequities that refer to differences in health for Healthy people 2020 are under review.
status and outcomes that are unjust, unfair, In addition to many of the health condi-
inhumane, unnecessary, and unacceptable tion–related objectives in Healthy people
express that difference unfairness or injus- 2010, a newer objective is focused on social
tices (Hebert, Sisk, & Howell, 2008). Thus, a determinants of health in which the “U.S.
related term as opposed to health disparities Department of Health and Human Services
is health equity. recognizing that categories intends to develop objectives for the social
of inequities and inequalities are not mutu- determinants and ensure their integration
ally exclusive, the focus on this section will across all Healthy people 2020 objectives”
be on health disparities of racial and ethnic (U.S. DHHS, 2009).
minority groups. Despite the improvement in over-
In the 1980s, the U.S. Department of all health of the U.S. population, profound
Health and Human Services (DHHS) cre- disparities in the burden of illness and
ated the Task Force on Black and Minority mortality continue to be experienced by
Health. It was convened “in response to a African Americans, Hispanics, American
national paradox of phenomenal scientific Indians, Alaska Natives, Asians, and Native
achievement and steady improvement in Hawaiians and pacific Islanders. The most
overall health status, while at the same time, striking of these disparities include shorter
persistent, significant health inequities exist life expectancy, higher rates of infant mortal-
for minority Americans” (U.S. DHHS, 1985, ity, cardiovascular disease, cancer, diabetes,
p. 2). The Task Force examined mortality data stroke, sexually transmitted infections, and
between minority groups and nonminority mental illness (Adler & Newman, 2002; Adler
groups to determine excess deaths. cancer, & rehkopf, 2008; Murray et al., 2006). These
cardiovascular disease and stroke, cirrhosis, disparities are believed to be a result of com-
diabetes, homicide and unintentional injuries, plex interactions among, social inequalities
and infant mortality accounted for more than in income, educational opportunities, hous-
80% of the mortality among minority popula- ing/environment, individual health behav-
tions. president clinton in 1998 focused atten- iors, and biological factors.
tion on health disparities confronted by racial Although there is no denying that health
and ethnic minority groups, which were disparities exist for racial and ethnic minori-
remarkably similar to those identified in 1985, ties, the cause of disparities and therefore the
with the exception of HIV/AIDS and pneu- design of appropriate strategies and interven-
monia and influenza. Finally, the creation tions to eliminate disparities is the subject
of the National center for Minority Health of many debates. Despite advances in med-
and Health Disparities within the NIH helps ical technology and health care spending
to focus research priorities and resources exceeding the amounts per capita of the GDp
toward eliminating health disparities. of many developing countries, overall health