Black-White health disparities in the United States and Chicago: a 15-year progress analysis.

OBJECTIVES In an effort to examine national and Chicago, Illinois, progress in meeting the Healthy People 2010 goal of eliminating health disparities, we examined whether disparities between non-Hispanic Black and non-Hispanic White persons widened, narrowed, or stayed the same between 1990 and 2005. METHODS We examined 15 health status indicators. We determined whether a disparity widened, narrowed, or remained unchanged between 1990 and 2005 by examining the percentage difference in rates between non-Hispanic Black and non-Hispanic White populations at both time points and at each location. We calculated P values to determine whether changes in percentage difference over time were statistically significant. RESULTS Disparities between non-Hispanic Black and non-Hispanic White populations widened for 6 of 15 health status indicators examined for the United States (5 significantly), whereas in Chicago the majority of disparities widened (11 of 15, 5 significantly). CONCLUSIONS Overall, progress toward meeting the Healthy People 2010 goal of eliminating health disparities in the United States and in Chicago remains bleak. With more than 15 years of time and effort spent at the national and local level to reduce disparities, the impact remains negligible.

[1]  John Lynch,et al.  Methodological issues in measuring health disparities. , 2005, Vital and health statistics. Series 2, Data evaluation and methods research.

[2]  P. Cleary,et al.  Racial disparities in access to renal transplantation--clinically appropriate or due to underuse or overuse? , 2000, The New England journal of medicine.

[3]  Richard J. T. Klein,et al.  Measuring progress in Healthy People 2010. , 2004, Healthy People 2010 statistical notes : from the Centers for Disease Control and Prevention/National Center for Health Statistics.

[4]  J. House,et al.  Toward a Better Estimation of the Effect of Job Loss on Health∗ , 2007, Journal of health and social behavior.

[5]  T. Mckeown The Role of Medicine , 1979 .

[6]  M. Susser,et al.  Sociology in medicine , 1963 .

[7]  S. Whitman Racial Disparities in Health: Taking it Personally , 2001, Public health reports.

[8]  M. Landen,et al.  The disparity change score: a new methodology to examine health disparities in New Mexico. , 2005, Journal of public health management and practice : JPHMP.

[9]  R. Cooper,et al.  Relationship between Premature Mortality and Socioeconomic Factors in Black and White Populations of US Metropolitan Areas , 2001, Public health reports.

[10]  Abigail Silva,et al.  Comparison of health status indicators in chicago: are Black-White disparities worsening? , 2004, American journal of public health.

[11]  N Krieger,et al.  Racial discrimination and blood pressure: the CARDIA Study of young black and white adults. , 1996, American journal of public health.

[12]  Diane K Wagener,et al.  Trends in racial and ethnic-specific rates for the health status indicators: United States, 1990-98. , 2002, Healthy People 2000 statistical notes.

[13]  T. Waidmann,et al.  Poverty, time, and place: variation in excess mortality across selected US populations, 1980-1990. , 1999, Journal of epidemiology and community health.

[14]  David R. Williams Race, Socioeconomic Status, and Health The Added Effects of Racism and Discrimination , 1999, Annals of the New York Academy of Sciences.

[15]  J. S. McCormick,et al.  THE ROLE OF MEDICINE. DREAM, MIRAGE OR NEMESIS , 1977 .

[16]  Bruce G. Link,et al.  Controlling disease and creating disparities: a fundamental cause perspective. , 2005, The journals of gerontology. Series B, Psychological sciences and social sciences.

[17]  Adrienne Y. Stith,et al.  Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care , 2005 .

[18]  H. Freeman The meaning of race in science‐‐considerations for cancer research , 1998, Cancer.

[19]  C. Hennekens,et al.  Black-White Inequalities in Mortality and Life Expectancy, 1933–1999: Implications for Healthy People 2010 , 2001, Public health reports (1974).

[20]  David R. Williams,et al.  Us socioeconomic and racial differences in health: patterns and explanations , 1995 .

[21]  J. Ayanian Determinants of Racial and Ethnic Disparities in Surgical Care , 2008, World Journal of Surgery.

[22]  N. Halfon,et al.  Racial and Ethnic Disparities in Birth Outcomes: A Life-Course Perspective , 2003, Maternal and Child Health Journal.

[23]  J. Pearcy,et al.  A Summary Measure of Health Disparity , 2002, Public health reports.

[24]  D. Ansell,et al.  The black:white disparity in breast cancer mortality: the example of Chicago , 2007, Cancer Causes & Control.

[25]  David R. Williams,et al.  Segregation and Mortality: The Deadly Effects of Racism? , 1999 .

[26]  Helen Margellos-Anast,et al.  The Pediatric Asthma Intervention: A Comprehensive Cost-Effective Approach to Asthma Management in a Disadvantaged Inner-City Community , 2007, The Journal of asthma : official journal of the Association for the Care of Asthma.

[27]  Evaluating Chicago's success in reaching the Healthy People 2000 goal of reducing health disparities. , 2001, Public health reports.

[28]  M. Fullilove Root Shock: How Tearing Up City Neighborhoods Hurts America, And What We Can Do About It , 2004 .

[29]  JonathanSkinner,et al.  Mortality After Acute Myocardial Infarction in Hospitals That Disproportionately Treat Black Patients , 2005 .

[30]  A. Epstein,et al.  Racial disparities in medical care. , 2001, The New England journal of medicine.

[31]  P. Parsons,et al.  Racial differences in health: not just black and white, but shades of gray. , 1996, Annual review of public health.

[32]  Jeffrey Geppert,et al.  Mortality among very low-birthweight infants in hospitals serving minority populations. , 2005, American journal of public health.

[33]  S V Subramanian,et al.  Painting a truer picture of US socioeconomic and racial/ethnic health inequalities: the Public Health Disparities Geocoding Project. , 2005, American journal of public health.

[34]  David R. Williams,et al.  Racial Residential Segregation: A Fundamental Cause of Racial Disparities in Health , 2001, Public health reports.

[35]  J. Kozol,et al.  The Shame of the Nation: The Restoration of Apartheid Schooling in America , 2005 .

[36]  D. Massey American Apartheid: Segregation and the Making of the Underclass , 1993 .

[37]  K. Keppel Ten largest racial and ethnic health disparities in the United States based on Healthy People 2010 Objectives. , 2007, American journal of epidemiology.