Group project
AsdMKJ
ch10.pptxChapter 10 Community and Public Health and Racial/Ethnic Minorities
Introduction
Strength of America lies in diversity of people
Diversity
U.S. population
Majority – white, non-Hispanic (63.4%)
Racial or ethnic minorities (36.6%)
Racial and Ethnic Classifications
Classifications used to operationalize race and ethnicity
Race – “categorization of parts of a population based on physical appearance due to particular historical social and political forces”
Ethnicity – subcultural group within a multicultural society; six main features
Health Data Sources and Their Limitations
Challenges to collection of race and ethnicity data
Unreliability of self-reported data
Barriers to data collection among health care providers
Classifications are social constructs that change over time and vary across societies and cultures
Biased analysis
HHS – works to increase reliability of data and amount of data collected
Americans of Hispanic Origin
Hispanic origin is an ethnicity, not a race
Largest minority group in U.S.
One of the most rapidly growing ethic groups in the U.S.
Education
Income
Health beliefs
African Americans
People having origins in any of the black racial groups from Africa
2nd largest minority group in U.S.
More than ½ live in southern states
Education
Income
Health beliefs
Asian Americans and Pacific Islanders
Asian Americans – people of Asian descent who trace their roots to more than 20 different Asian countries
Pacific Islanders – peoples of Hawaii, Guam, Samoa, or other Pacific Islands and their descendants
Education
Income
Health beliefs
American Indians and Alaska Natives
Original inhabitants of America
Relatively poor health status
Education
Income
Health beliefs
U.S. Gov’t, Native Americans, and Provision of 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
Immigrant and Refugee Health
Refugees
Immigrants
Aliens
Unauthorized Immigrants
Can be classified into existing racial/ethnic groups; as a single group, present special concerns
Minority Health and Health Disparities
Minority Health
Health Disparities
Federal efforts to eliminate health disparities
Race and Health Initiative
Goal: eliminate disparities among racial and ethnic minority populations in six areas
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
African Americans infant death rate more than two times that of white Americans
Lack of prenatal care and low-birth-weight babies
Infant Mortality Rates by Race and Hispanic Origin of Mother, U.S.
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
Cancer Incidence and Death Rates, U.S., by Cancer Site and Race
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
Age-Adjusted Prevalence of Diagnosed or Undiagnosed Hypertension in Adults
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
Diabetes Age-Adjusted Prevalence by Race/Ethnicity, U.S.
HIV Infection/AIDS
Proportional distribution of AIDS cases has increased in African 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
Rates of Diagnoses of HIV Infection among Adults and Adolescents by Race/Ethnicity
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
Socioeconomic status (SES) considered the most influential single contributor to premature morbidity and mortality
Education, level of income, poverty
Strong associations between SES factors and health outcomes
Relationship can be described as gradient
Relationship Between Race and Health
Health Status by Race, Ethnicity, and Income
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
Discussion Questions
Why have there been so many changes to racial and ethnic classifications in the United States in recent decades?
How can community health programs empower minority groups?
