African Americans: disparities in health care access and utilization.

摘要: Despite remarkable improvements in the overall health of our nation during past two decades, compelling evidence suggests that nation's racial and ethnic minority Americans suffer increasing disparities incidence, prevalence, mortality, burden diseases adverse outcomes compared with white Americans. The 1998 Presidential Initiative on Race Health was first national commitment to eliminate between majority population groups. Because groups will increase nearly 40 percent U.S. by 2030 (U.S. Department Human Services [HHS] 2000), a stronger better understand develop new diagnostic, treatment, prevention strategies for their elimination is sound investment. Only rigorous epidemiologic research can discern where these exist, define scope problem, identify evaluate interventions reduce them. Sources are multivariate, complex, rooted an inequitable care system. Contributing factors include lack access care; barriers increased risk disability disease resulting from occupational exposure; biological, socioeconomic, ethnic, family factors; cultural values education; social relationships groups; autonomous institutions within group populations; culturally insensitive systems (Geronimus, 2000; HHS, 2001b; Jackson et al., 2001; Smedley, Stith, & Nelson, 2003). practice implications deserve attention professionals, administrators, policymakers, consumers. pose moral ethical dilemmas rapidly changing They threaten efforts improve create problems society continues struggle legacy discrimination oppression. resources tied justice, opportunity, quality life, productivity workforce linked status its workers. cost inadequate has huge impact expenditures. In final analysis, prompt concerns about Unites States (Smedley professional work compel us participate fight system sensitive needs all, regardless race or ethnicity. Service equity part call justice. Having diverse asset challenge nation. Racial occur among several subpopulation groups: American Indians, Alaska Natives, Asian Pacific Islanders, Hispanic Americans; rural urban infants, children, youths; adults senior citizens, so forth. this column does not permit in-depth discussion relationship characteristics unique each group. Nor it appropriate approach disparity problem ethnically blind perspective. focus African Americans, who have history United States, slavery, emancipation, segregation, racism, discrimination. AFRICAN AMERICANS AND HEALTH DISPARITIES Approximately 12 (34.7 million) (HHS, 1999). Compared they less likely private employment-based insurance, more be covered Medicaid other publicly funded twice as uninsured, even though eight 10 working families. …