Study Finds Unhealthy Dose Of Race Disparities

In the latest comprehensive look at minority health in the state, blacks and American Indians fare worse than other populations, likely because of higher rates of disease and preventable deaths such as homicides, according to a new state study.

The report, an update of a 1993 study, also found that minority populations were more likely to lack continuous health insurance coverage and to receive less than optimal care, two factors believed to contribute to poor health conditions.

A similar gap between whites and other racial and ethnic groups exists nationally, but many of the Wisconsin rates outlined in the study are wider, according to the report and national statistics.

As a result, there is a need for improved health care strategies here, according to the Wisconsin Minority Health Report, released by the state Department of Health and Family Services.

“These findings are very serious and unacceptable,” said department Secretary Helene Nelson. “The question is: Can we overcome this? The answer is: We must.”

According to the report, the homicide rate among blacks was more than 20 times that of whites, accounting for 58% of deaths among 15- to 24-year-old black males and 25% of deaths among similarly aged black females.

In addition, the rate of newly reported HIV infection was 13 times the rate of infection for whites, the study showed.

Among American Indians, the rate of death from diabetes was six times more than whites, the report shows.

Among other findings in the report:

The rate of hospitalization for depression was 137 per 100,000 for blacks compared with 81 for whites, while the rates for schizophrenia was 373 per 100,000 for blacks compared with 81 for whites.

American Indians had the highest annual rate of suicide, 15 deaths per 100,000 compared with 11 per 100,000 for whites and Asians.

The rate of cervical cancer was three times higher in Asian women than white women.

Asians were more likely to have tuberculosis with an average rate of 35 cases per 100,000 reported during the study period, compared with 2 per 100,000 cases for whites.

Asian hospitalization rates for alcohol and drug abuse was lowest among all groups studied.

The mortality rate among Latinos was 337 deaths per 100,000, lower than the national rate of 606 deaths per 100,000 for Latinos.

The rate of hospitalization for asthma among Hispanics and Latinos was almost twice the rate for whites.

Though many of the findings are not surprising, Nelson said the report serves as “a platform to move from statistics toward solutions.”

The Wisconsin report was based on several sources, including birth and death records, hospital discharge data and behavioral risk and family surveys. Though the majority of the report analyzed data from 1996 to 2000, a few sections included data from 2002 and 2003.

Health disparities in Wisconsin and throughout the nation are not new, but finding ways to eliminate them has proved to be a huge challenge, said Denise Carty, minority health officer in the division of public health at the state Department of Health and Family Services.

“Our focus is to see if we can address systems because it’s not helpful to just address particular diseases,” she said.

For example, many problems result from lack of access to health care, lack of support for minority health professionals and not having culturally competent practices in place to help eliminate disparities, she said. Carty said the state has initiated a two-year partnership with local communities to address health disparities in their areas.

Earlier this year, a first-of-its-kind report by the Agency for Healthcare Research and Quality validated national disparities in health care, though its final version had been edited and drew complaints that it played down serious problems.

The theme of the original draft was that members of minorities “tend to be in poorer health than other Americans” and that “disparities are pervasive in our health care system,” contributing to higher rates of disease and disability.

In contrast, the final report has an upbeat tone, beginning: “The overall health of Americans has improved dramatically over the last century.”

Health and Human Services Secretary Tommy G. Thompson acknowledged that his department erred in making changes that included eliminating the conclusion that unequal care for minorities is a national problem.