Ethnicity and Lifestyle Health Risk: Some Possible Mechanisms

Lawrence W. Green, Dr. P.H., is Professor and Director at the Center for Health Promotion Research and Development at the University of Texas Health Science Center at Houston. Ethnic differences in health status and in behavioral risk are increasingly becoming a focus for public policy in the United States. 1-3 Each year minorities in the U.S. experience at least 60,000 excess deaths (deaths beyond the numbers they would have experienced if they had the same sex and age-adjusted rates as the white population). Heart disease is responsible for the most excess deaths cumulative to age 70 in these groups. 2,~ Behavioral risk factors, including smoking, alcohol use, obesity, and lack of exercise, contribute to this burden of illness.* Health promotion and disease prevention services have not been distributed equally across all population groups? Although there are some notable exceptions such as the Planned Approach to Community Health Projects funded by the Centers for Disease Control 6, health promotion has been a white middleclass phenomenon. Participants in these lifestyle behavior change programs typically are motivated individuals who are affluent enough to purchase the services or who work in companies which make them available as a benefit.