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ERIC ED415313: Assessment of the Status of African-Americans. Volume V: Health and Medical Care of African-Americans. PDF

167 Pages·1992·2.3 MB·English
by  ERIC
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DOCUMENT RESUME UD 032 093 ED 415 313 Reed, Wornie L.; Darity, William, Sr.; Roman, Stanford; AUTHOR Baguet, Claudia; Roberson, Norma L. Assessment of the Status of African-Americans. Volume V: TITLE Health and Medical Care of African-Americans. Massachusetts Univ., Boston, MA. William Monroe Trotter INSTITUTION Inst. ISBN-1-878358-01-4 ISBN 1992-00-00 PUB DATE 189p.; For Volumes I through VI, see UD 032 089-094. NOTE Evaluative -- Reports General (020) Collected Works PUB TYPE (142) MF01/PC08 Plus Postage. EDRS PRICE *Blacks; Demography; *Health Conditions; *Medical Services; DESCRIPTORS *Racial Differences; Racial Discrimination; *Social Change; *Socioeconomic Status; Urban Youth *African Americans; National Research Council IDENTIFIERS ABSTRACT In 1987 a project was undertaken to assess the status of African Americans in the United States in the topical areas to be addressed by the National Ressarch Council's Study Committee on the Status of Black Americans: education, employment, income and occupations, political cultural change, participation and the administration or justice, health status and medical care, and the family. Six volumes resulted front this study. This volume, the fifth, explores the health status of African Americans. For many health status indicators the rates are improving for blacks as well as whites. However, a racial gap still remains, and in some instances the gap has increased over the past decade of two. In a search for relevant factors associated with these trends, health issues are examined in (1) "Health Status and Sociodemographic Context"; the following chapters: (2) "Adverse Birth Outcomes: Infant Mortality, Low Birth Weight, and Maternal "Cancer Incidence and Mortality among African-Americans"; (4) Deaths"; (3) "Lead Poisoning: The "Trends in Homicide among African-Americans"; (5) "Current Plagues: Chemical Dependency and AIDS"; (7) Invisible Epidemic"; (6) (9) "Health Work Force "Access to Medical Care"; "Sickel Cell Anemia"; (8) "Cross-Cutting Issues in the Health of Distribution"; and (10) African-Americans." Medical care alone will not reduce the great disparities in health status between black and white Americans completely. To redress these inequities, other aspects of society must change, and it must be understood that disease is rooted in social structure. An appendix lists project study group members and contributors. Each chapter contains references. (Contains 1 figure and 64 tables.) (SLD) ******************************************************************************** Reproductions supplied by EDRS are the best that can be made from the original document. ******************************************************************************** Health and Medical Care of African-Americans Assessment of the Status of African-Americans Volume V U.S. DEPARTMENT OF EDUCATION Ditto of Educational Research and Improvement ED TIONAL RESOURCES INFORMATION CENTER (ERIC) his document has been reproduced as eceived from the person or organization originating it. O Minor changes have been made to improve reproduction quality. Points of view or opinions stated in thiS docu- ment do not necessarily represent official OERI position or policy. PERMISSION TO REPRODUCE AND DISSEMINATE THIS MATERIAL HAS BEEN GRANTED BY As Ike lnsf. -r-r (' TO THE EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC) 1 The William Monroe Trotter Institute University of Massachusetts at Boston LBLE BEST COPY AV The Health and Medical Care of African-Americans Volume V Wornie L. Reed with William Darity, Sr. Stanford Roman Claudia Baguet Noma L. Roberson William Monroe Trotter Institute University of Massachusetts at Boston 1992 3 © 1992 by William Monroe Trotter Institute ISBN 1-878358-01-4 4 Table of Contents Preface v Health Status and Sociodemographic Context 1. 1 Adverse Birth Outcomes: Infant Mortality, 2. Low Birth Weight, and Maternal Deaths 17 Cancer Incidence and Mortality Among 3. African-Americans 33 Trends in Homicide Among African-Americans 55 4. Lead Poisoning: The Invisible Epidemic 69 5. Current Plagues: Chemical Dependency and AIDS 79 6. Sickle Cell Anemia 99 7. Access to Medical Care 113 8. Health Work Force Distribution 141 9. 10. Cross-Cutting Issues in the Health of African-Americans 155 Appendix: Assessment of the Status of African-Americans Project Study Group Members and Contributors 159 PREFACE In the Spring of 1987 the William Monroe Trotter Institute at the University of Massachusetts at Boston initiated a project entitled, "The Assessment of the Status of African-Americans." Thirty-five scholars were organized into study groups, one for each of six topics: education; employment, income, and occupations; political partici- pation and the administration of justice; social and cultural change; health status and medical care; and the family. The study groups were established to analyze the status of African-Americans in each of the topical areas in anticipation of the results and analyses of the National Research Council's Study Committee on the Status of Black Americans. We wanted to have the widest possible discussion of the present condition of blacks and the social policy implications of that condition. The multidisciplinary group of scholars comprising the study groups included persons from all sections of the country and from varied settingsprivate and public universities, historically black universities, and private agencies. A list of these scholars by study group is given in the Appendix. Each of the study groups met and drafted an agenda for examining significant issues under their respective topics. Members chose issues from this agenda within their areas of expertise and identified other scholars who had written extensively on other issues on the agenda. These oth- er scholars made a variety of contributions, including original papers, reprints, notes and materials, and/or substantial commentaries on draft documents. Despite the pressures of limited time and limited financial support for this work, six volumes were produced: Summary Volume I: Research on the African-American Family: A Holistic Perspective Volume II: The Education of African-Americans Volume DI: Volume IV: Social, Political, and Economic Issues in Black America The Health and Medical Care of African-Americans Volume V: Volume W: Critiques of NRC Study, A Common Destiny: Blacks and American Society Each of the study groups developed its own conclusion and policy recommendations. In addition to study group members and other contributors, we are indebted to a number of individuals for the production of this study. We owe thanks to Phillip Hal- len and the Maurice Falk Foundation for underwriting the costs of producing these volumes. Special thanks are also offered to the following persons: our editors, Su- zanne Baker and Linda Kluz, and our production staff, Eva Hendricks and Gemima Remy. During production of this volume I relocated from the University of Massachu- setts at Boston to Cleveland State University. Special thanks are given to Dr. James Jennings, Interim Director of the Trotter Institute, for supporting the completion of this volume. Wornie L. Reed 6 1 Health Status and Sociodemographic Context The consequences and the legacy of racism and racial discrimination are serious matters. These issues are often thought of in terms of attitudes and inconveniences. However, institutional racism affects the life chances of African-Americans-i.e., how well and how long they live. Racial disadvantages in the United States-especially as they relate to blacks in comparison to whites-are nowhere more telling and perhaps more significant than in mortality rates and life expectancy. Blacks do not live as long as whites. The seriousness of the health status of African-Americans in urban areas was shown in a recent study that compared the mortality rates of blacks in Harlem to those of whites in New York City (McCord and Freeman, 1990). Blacks were several times more likely to die than whites. In fact, the life expectancy of black males in the central Harlem district was found to be lower than that of males in Bangladesh; and Bangladesh is categorized by the World Bank as one of the poorest countries in the world. The McCord and Freeman study also profiled the socioeconomic conditions in Harlem: Harlem is 96% black, and 41% of the population lives below the poverty It is becoming increasingly apparent that health problems confronting the line. black community are directly related to socioeconomic conditions. Before providing brief sociode- an overview of the health status of African-Americans we will provide a mographic context. Sociodemographic Context In 1987 blacks were more than three times as likely to be below the poverty lev- el as whites, a situation that has persisted for several decades (table 1-1). Children and the elderly are more likely than other age groups to be below the poverty level for whites as well as blacks; however, the same racial ratio obtains-black children and older persons are more than three times as likely to be below the poverty level than white children and older persons (U.S. Department of Health and Human Services, 1990). High school graduation rates are a significant indicator of actual as well as po- tential socioeconomic status. Therefore, the upward trend of this statistic since 1970 is a positive development-both black males and black females had increases in high school graduation rates. However, in 1986 the non-high school graduation rate for blacks was still significantly higher than that for whites (See table 1-2). 7 2 The Health and Medical Care of African-Americans Table 1-1 Percent of Persons Below the Poverty Level, by Race: United States, Selected Years, 1960-1987 Race Year White Black 1960 17.8 55.9a 1962 16.4 55.8a 1964 49.6a 14.9 1966 41.8 11.3 1968 34.7 10.0 1970 9.4 33.5 1972 9.0 33.3 1974 8.6 30.3 1976 9.1 31.1 1978 30.6 8.7 1980 32.5 10.2 1982 35.6 12.0 1984 33.8 11.5 1986 11.0 33.1 1987 33.1 10.5 aPrior to 1966, category includes blacks and other races. U.S. Department of Health and Human Services. (1990). Health Status of Source: the Disadvantaged-Chartbook 1990. DHHS Pub. No. (HRSA) HRS-P-DV 90-1. Washington, DC: U.S. Government Printing Office. S Health Status 3 Table 1-2 Persons Not Enrolled in School and Not High School Graduates, by Age, Race, and Sex: United States, Selected Years, 1970-1986 Age Total Characteristic by Year 16-24 yrs. 16-17 yrs. 20-24 yrs. 18-19 yrs. (Percent) 1970 White male 12.2 13.3 14.8 6.3 White female 8.4 14.1 14.8 16.3 Black male 29.4 36.4 35.4 13.1 Black female 12.4 26.6 26.6 35.5 1972 White male 13.5 15.3 13.0 7.8 White female 14.2 9.6 16.6 13.2 Black male 9.4 22.3 27.2 27.1 Black female 21.0 20.8 27.3 7.6 1974 White male 9.4 17.4 13.4 13.6 White female 14.5 13.9 13.1 9.1 Black male 23.6 26.9 20.1 8.3 Black female 22.3 20.2 27.7 12.6 1976 White male 14.1 13.2 7.6 17.1 White female 15.4 14.1 9.1 13.3 Black male 21.2 29.6 19.3 8.1 Black female 23.5 20.7 19.7 10.8 1978 White male 13.9 14.9 8.6 17.0 White female 14.8 12.8 9.1 13.5 Black male 23.8 24.3 19.4 6.9 Black female 8.4 20.0 25.1 20.3 1980 White male 9.3 14.2 15.5 16.1 White female 9.2 12.9 12.3 13.8 Black male 27.6 22.7 21.1 7.1 Black female 21.7 19.9 6.7 17.9 9 The Health and Medical Care of African-Americans 4 Table 1-2 (continued) Persons Not Enrolled in School and Not High School Graduates, by Age, Race, and Sex: United States, Selected Years, 1970-1986 Age Total 20-24 yrs. 18-19 yrs. Characteristic by Year 16-17 yrs. 16-24 yrs. 1982 14.7 16.6 White male 7.2 13.6 13.5 14.9 White female 8.0 12.7 26.4 25.3 Black male 21.1 6.4 19.1 Black female 18.1 16.0 5.5 1984 14.9 White male 15.8 7.4 13.5 12.6 14.0 White female 11.8 6.9 20.1 Black male 19.7 16.7 5.5 14.4 18.0 Black female 4.9 14.5 1986 15.3 12.8 White male 12.9 6.9 12.9 11.0 White female 11.1 6.0 19.6 14.6 Black male 4.7 14.9 16.0 15.2 4.7 Black female 13.4 U.S. Department of Health and Human Services. (1990). Health Status of Source: the Disadvantaged-Chartbook 1990. DHHS Pub. No. (HRSA) HRS-P-DV 90-1. Washington, DC: U.S. Government Printing Office.

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