Disparities_08 - Health Disparities PAM 435 April 15, 2008...

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Health Disparities PAM 435 April 15, 2008
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Today’s Objectives Although there are differences in health and use of medical services between many groups within the U.S., we will focus on differences: - between blacks and whites - between men and women (to a lesser extent) 1) How large are these differences? 1) Why do these differences exist?
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0 10 20 30 40 50 60 70 80 90 1900 1950 1960 1970 1980 1990 2000 2004 White Black Source: National Center for Health Statistics, 2007. Difference 15.2 9.3 7.8 7.3 5.6 5.8 4.9 4.5 (years) Life Expectancy at Birth for Females Racial Life Expectancy Gap Has Narrowed Over Time
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0 5 10 15 20 25 30 35 40 45 50 1950 1960 1970 1980 1990 2000 2004 White Black Source: National Center for Health Statistics, 2007. Difference 17.5 21.5 14.5 11.5 9.6 7.8 7.5 (years) Infant Mortality Rates (per 1,000 live births) Differences in Early-life Mortality Are Critical
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% of Cancer Patients Surviving for 5 Years, 1996-2003 0 10 20 30 40 50 60 70 80 90 Bladder All sites Colon Leukemia Lung White Black Source: SEER data. Differences Also Exist for Diseases That Usually Strike Later in Life
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Hispanics & Blacks Less Likely to Receive a Colonoscopy
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Whites Are Least Likely to Report Having Fair or Poor Health 13% 8% 13% 15% 9% 17% 0% 20% SOURCE: Health, United States, 2006, Table 60. Self-reported % with fair or poor health, 2004 White (Non-Hispanic) Hispanic African American (Non- Hispanic) Asian Only* American Indian/ Alaska Native Two or More Races
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What might explain racial differences in health and use of medical services?
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Possible Explanations 1) Socioeconomic differences that have an independent effect on health and access to medical services: a) Income b) Health insurance c) Education 2) Differences in health behaviors 3) Differences in preferences 4) Discrimination – conscious or subconscious – by physicians and/or other health providers
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Poverty Status of the Nonelderly Population by Race/Ethnicity, 2005 NOTE: FPL = Federal Poverty Level. The FPL for a family of four in 2005 was $19,971. SOURCE: Urban Institute and Kaiser Commission on Medicaid and the Uninsured, CPS. 21% 20% 74% 42% 46% 68% 43% 59% Non-Poor (200% + FPL) Near Poor (100% - 199% FPL) Poor (<100%FPL) 166.6 million 40.8 million 32.6 million 11.8 million 1.5 million Nonelderly White (Non-Hispanic) Hispanic African American (Non-Hispanic) Asian Only American Indian/Alaska Native Two or More Races 4.2 million 29% 29% 21% 33% 23% 34% 14% 12% 16% 17% 1. Income Differences
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Poor People Generally Have Worse Health Than Rich People
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Source: Lin et al., 2003, NLMS.
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This note was uploaded on 09/12/2008 for the course PAM 4350 taught by Professor Nicholson during the Spring '08 term at Cornell University (Engineering School).

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Disparities_08 - Health Disparities PAM 435 April 15, 2008...

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