RACIAL
MINORITIES
AND HEALTH
DISPARITIES
By: Vaisali Patel
Trivia Time!
Can You Guess?

According to the U.S. Census Bureau’s
Population Clock, as of January 01,
2013, the population of the United States
is:
 A) 316, 929, 000
 B) 308, 745, 538
 C) 272, 690, 813
 D) 246, 819, 230
Can You Guess?

Minorities make up __________ % of
the U.S. population.
 25.4
 15.8
 36.6
 51.3
Can You Guess?

___________ are the fastest growing
racial group according to recent
reports by the U.S. Census Bureau.
Hispanics
African
Americans
Native Americans
Asians
Can You Guess?

True or False?
Among
preschool children who were
hospitalized for asthma, only 7% of
African American and 2% of Hispanic
children are prescribed routine
medications to prevent future asthmarelated hospitalizations, compared to
21% of White children.
Boe, G. (2009). The scoreboard on racial and ethnic disparities in health care. Journal of Continuing Education Topics & Issues, 11(1).
Can You Guess?

True or False?
Asian American, Hispanic, and
African American residents of
nursing homes are all far less likely
than White residents to have
sensory and communication aids,
such as glasses and hearing aids.
A Glimpse into the Future

It is projected that by 2060, the White population
is projected to fall to 43%
 Minorities
2060
will comprise 57% of the population by
A Glimpse into the Future
 By
2060, the U.S. Census Bureau predicts:
 Hispanic
population would more than double,
from 53.3 million in 2012 to 128.8 million in
2060
 African
American population is expected to
increase from 41.2 million to 61.8 million
A Glimpse into the Future

By 2043, the U.S. Census Bureau predicts (Cont’d):
 Asian
population is projected to more than double, from
15.9 million in 2012 to 34.4 million in 2060
 American Indians and Alaska Natives would increase by
more than half from now to 2060, from 3.9 million to 6.3
million
A Glimpse Into The Future
By 2043, no group will
make up a majority.
So WHAT is the Problem?

Access to insurance

Differences in income
So WHAT is the Problem?
But that isn’t all. Don’t forget the:
 Physicians
 Stereotypes
 Decision-making
 Hospital Characteristics
 Quality of Care
 Cultural and Communication Barriers
What is High-Quality Care?

The Institute of Medicine (IOM) states 6
characteristics that must be present in order to be
considered as high-quality care:
(1) Safe – Care avoids causing injury to
patients from the care provided.
(2) Timely – Wait times and delays are
minimized for those who receive and provide
care.
What is High-Quality Care?

IOM characteristics (Cont’d):
(3) Effective – Services are provided based on
scientific knowledge to all who could benefit
and are not provided to those who would not
benefit.
(4) Efficient – Care avoids wasting equipment,
supplies, ideas, and energy.
What is High-Quality Care?

IOM Characteristics (Cont’d)
(5) Patient-Centered – Care is delivered with
“compassion, empathy, and responsiveness to the
need, values, and expressed preferences of the
individual patient” and ensures that patients “have the
education and support they need to make decisions and
participate in their own care.”
(6) Equitable – Care does not vary in quality
because of personal characteristics, including gender,
ethnicity, geographic location, or socioeconomic status
Burstein, H. J., Prestrud, A. A., Seidenfeld, J., Anderson, H., Buchholz, T. A., Davidson, N. E., & Griggs, J. J. (2010). American
Society of Clinical Oncology clinical practice guideline: Update on adjuvant endocrine therapy for women with hormone
receptor–positive breast cancer. Journal of Clinical Oncology, 28(23), 3784-3796.
Quality of Healthcare and Minorities

Safety: Hispanics and Asians are
more likely to die from
complications in a hospital
compared to non-Hispanic
Whites.

Safety: In one study, black youths
were two times more likely and
Hispanic youths were 70 percent
more likely than White youths to
have restraints upon admission to
a psychiatric hospital, even when
controlled for psychiatric
condition.
Quality of Healthcare and Minorities

Timeliness: minorities are less
likely to get a same day or next
day appointment to see a doctor
than whites and are more likely
to be unable to get an
appointment until six or more
days later

Timeliness: Studies have shown
that even when age, sex, hospital
characteristics, insurance status,
and other factors are controlled,
minority patients still had longer
door-to-balloon times than white
patients.
Quality of Healthcare and Minorities

Effectiveness: Hispanic and Asian
women also have lower rates of
mammograms than non-Hispanic
white and black women.

Effectiveness: American
Indian/Alaska Native women are
the least likely of all races and
ethnicities examined to have had
prenatal care in their first
trimester, despite a federal
program dedicated to providing
health services for American
Indians and Alaska Natives.
Quality of Healthcare and Minorities

Efficiency: African Americans and
Hispanics are more likely than
Whites to be hospitalized for
diabetes and pediatric asthma.

Efficiency: African Americans also
have higher rates of admission to
the intensive care unit in their last
months of life.
Quality of Healthcare and Minorities

Patient-Centeredness: Adults
whose primary language is not
English are more likely to report
that their providers sometimes or
never listened carefully,
explained things clearly,
respected what they said, and
spent enough time with them.

Patient-Centeredness: Asian or
Pacific Islander hospice patients
are least likely to receive end-oflife care consistent with their
wishes.
Quality of Healthcare and Minorities

Equitable: The quality of care offered should not
differ due to the physician’s preconceived
assumptions about a particular race or ethnicity,
gender, or socioeconomic status.
Is this a Public Health issue?

YES!
 If
racial and ethnic disparities in health and
healthcare continue unchanged, many more
Americans will be at risk of disease and poor
quality health care.
Quality of Healthcare and Minorities

No matter what the factors may be, morally and
ethically, everyone should receive the high-quality
healthcare.
References

Addressing racial and ethnic disparities in health care. (2013, April). Agency for Healthcare Research and Quality. Rockville,
MD. Retrieved from http://www.ahrq.gov/research/findings/factsheets/minority/disparit/index.html

Burstein, H. J., Prestrud, A. A., Seidenfeld, J., Anderson, H., Buchholz, T. A., Davidson, N. E., & Griggs, J. J. (2010). American
Society of Clinical Oncology clinical practice guideline: Update on adjuvant endocrine therapy for women with
hormone receptor–positive breast cancer. Journal of Clinical Oncology, 28(23), 3784-3796.

Boe, G. (2009). The scoreboard on racial and ethnic disparities in health care. Journal of Continuing Education Topics & Issues, 11(1).

Connolly, C. (2002, March 21). Report says minorities get lower-quality health care. The Washington Post. Retrieved from
http://www.healthpronet.org/prog_resources/news_041502a.html

Hasnain-Wynia, R., Baker, D. W., Nerenz, D., et al. (2007). Disparities in health care are driven by where minority patients
seek care. Archives of Internal Medicine, 167(12).

Humes, K., Jones, N., & Ramirez, R. (2011). Overview of race and Hispanic origin: 2010. 2010 Census Briefs.

Nhan, D. (2012, May 17). Census: Minorities constitute 37 percent of U.S. population. National Journal. Retrieved
fromhttp://www.nationaljournal.com/thenextamerica/demographics/census-minorities-constitute-37-percent-of-u-spopulation-20120517
References

Rama, P. (2012, March 23). U.S. Census show Asians are fastest growing racial group.
The Two-Way. Retrieved from http://www.npr.org/blogs/thetwoway/2012/03/23/149244806/u-s-census-show-asians-are-fastest-growing-racialgroup

Stuart, E., & Betar, T. (2012, June 27). Minorities face hurdles in getting health care. Desert
News. Retrieved from http://www.deseretnews.com/article/765586481/Minorities-facehurdles-in-getting-health-care.html?pg=all

U.S. Census Bureau. (2012). U.S. Census Bureau projections show a slower growing, older, more
diverse nation a half century from now. Retrieved from
https://www.census.gov/newsroom/releases/archives/population/cb12-243.html

U.S. Census Bureau. (2013). State and county quickfacts. Retrieved from
http://quickfacts.census.gov/qfd/states/00000.html

U.S. Census Bureau. (2013). U.S. & world population clocks. Retrieved from
http://www.census.gov/main/www/popclock.html