Source: Health Equity, Social Determinants | The Community Guide
Health equity exists when individuals have equal opportunities to be healthy. The ability to be healthy is often associated with factors such as social position, race, ethnicity, gender, religion, sexual identity, or disability. When these factors limit a person’s ability to be healthy it can lead to health inequity.
Health inequities are caused by the uneven distribution of social determinants of health. Social determinants include education, housing, and the neighborhood environment (e.g., sidewalks, parks), access to transportation, employment opportunities, the law and the justice systems, and health care and public health systems. Social determinants of health affect a person’s ability to earn a good living, live and work in a safe and healthy environment, and effectively use available resources including health care resources. Sometimes populations that represent a specific demographic feature (e.g., a particular racial or ethnic group) do not have equal access to quality education, housing, and other resources which can lead to greater sickness, and increased injuries and deaths.
Current Community Guide reviews are focused on interventions to reduce health inequities among racial and ethnic minorities and low-income populations.
Racial Disparities in Age-Specific Mortality Among Blacks or African Americans — United States, 1999–2015
Source: Vital Signs: Racial Disparities in Age-Specific Mortality Among Blacks or African Americans — United States, 1999–2015 | MMWR
Background: Although the overall life expectancy at birth has increased for both blacks and whites and the gap between these populations has narrowed, disparities in life expectancy and the leading causes of death for blacks compared with whites in the United States remain substantial. Understanding how factors that influence these disparities vary across the life span might enhance the targeting of appropriate interventions.
Methods: Trends during 1999–2015 in mortality rates for the leading causes of death were examined by black and white race and age group. Multiple 2014 and 2015 national data sources were analyzed to compare blacks with whites in selected age groups by sociodemographic characteristics, self-reported health behaviors, health-related quality of life indicators, use of health services, and chronic conditions.
Results: During 1999–2015, age-adjusted death rates decreased significantly in both populations, with rates declining more sharply among blacks for most leading causes of death. Thus, the disparity gap in all-cause mortality rates narrowed from 33% in 1999 to 16% in 2015. However, during 2015, blacks still had higher death rates than whites for all-cause mortality in all groups aged <65 years. Compared with whites, blacks in age groups <65 years had higher levels of some self-reported risk factors and chronic diseases and mortality from cardiovascular diseases and cancer, diseases that are most common among persons aged ≥65 years.
Conclusions and Implications for Public Health Practice: To continue to reduce the gap in health disparities, these findings suggest an ongoing need for universal and targeted interventions that address the leading causes of deaths among blacks (especially cardiovascular disease and cancer and their risk factors) across the life span and create equal opportunities for health.
As the U.S. Hispanic population grows, reaching nearly 57 million in 2015 and making up 18% of the nation’s population, it is becoming increasingly important to represent Hispanics in surveys of the U.S. population and to understand their opinions and behavior. But surveying Hispanics is complicated for many reasons – language barriers, sampling issues and cultural differences – that are the subject of a growing field of inquiry. This report explores some the unique challenges currently facing survey researchers in reaching Hispanics and offers considerations on how to meet those challenges based on the research literature and our experiences in fielding the Pew Research Center’s National Survey of Latinos.
Source: The Unique Challenges of Surveying U.S. Latinos | Pew Research Center
By Anna Brown
Designing the Survey Questionnaire: Stress Confidentiality, Translate with Cultural Context in Mind
A respondent’s answer to a survey question, or even their decision to participate in the survey at all, is a product of social and cognitive context and may differ across racial and ethnic groups. In fact, studies have shown that Hispanics are more likely to refuse to participate in surveys, or having agreed to take a survey, more likely to refuse to answer individual questions under some circumstances. This disproportionate refusal rate may in part be driven by a general suspicion of government or a more specific fear of deportation among subgroups of the U.S. Hispanic population, including unauthorized immigrants. Introductory language at the start of the questionnaire that stresses the random selection of the respondent and confidentiality of responses can help to mitigate this risk, though experience suggests it will not mitigate it entirely.
Michael López, Kerry Hofer, Erin Bumgarner, and Djaniele Taylor
A changing population According to 2013 U.S. Census data: • 48 percent of children under the age of 18 were members of racial/ethnic groups other than nonHispanic white. • Of this group, Hispanics represented the largest racial/ethnic group (24 percent), followed by nonHispanic blacks (14 percent) and non-Hispanic Asians (5 percent). • Hispanics also are a fast-growing racial/ethnic group, almost tripling as a share of the U.S. population between 1980 (9 percent) and 2013 (24 percent). a Across that culturally and linguistically diverse population, however, there is great variability within any given racial/ethnic group. Understanding the variability within and across racial/ethnic subgroups is an important step any organization must take to ensure its services are culturally responsive to the needs of its targeted population.