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

167 Pages·1992·2.3 MB·English

by  ERIC

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)
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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
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eceived from the
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PERMISSION TO REPRODUCE
AND
DISSEMINATE THIS MATERIAL
HAS
BEEN GRANTED BY
As
Ike lnsf.
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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.