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Race & Ethnicity

 Understanding racial & ethnic disparities 

Per the CDC's 2015 Health Report, "race is a social construct influenced by a complex set of factors. Because of the complexity and difficulty in conceptualizing and defining race, as well as the increasing representation of racial and ethnic subgroups in the United States, racial classification and data collection systems continue to evolve and expand." For that reason, this guide cannot fully explore and delineate the many changing facets of race and ethnicity in American healthcare systems. Racial dynamics are intersectional and often blurry in their own right, and this is increased when viewed through the frames of ethnicity, gender, age, ability, and geography. 

This guide does affirm the complexities of race in the United States, but attempts a balance between complexity and usability by dividing up racial and ethnic health care disparities into explicit categories, being: Asian Americans, Indian Americans and Arabic Americans, Black Americans, Hispanic Americans, Native & Alaskan Native Americans. There is also a page dedicated to the specific healthcare disparities experienced by persons with an immigrant status.

Each category includes healthcare resources that address disparities relevant to the corresponding racial/ethnic group. Because all persons who belong to a racial/ethnic minority group experience some level of disparity in health and healthcare, some resources will be similar, and others will vary. Taking into account the inadequacies of a guide like this, it is still vital to understand the interplay between healthcare and race/ethnicity in the United States because all racial and ethnic minorities in America share characteristics "associated with health risk factors, disease prevalence, and access to care, which in turn drive health care utilization and expenditures." (, 2015)

 Racial & ethnic disparities affect: 

  • Access to healthcare services
  • Health insurance coverage
  • Hypertension
  • Infant mortality
  • Longevity of life
  • Obesity
  • Prevalence of diabetes
  • Prevalence of STIs
  • Vaccination
  • Vision and dental care

 Pertinent resources  

 Disparities in immigrant populations 

Nonelderly lawfully present and undocumented immigrants are more likely to be uninsured than nonelderly U.S. citizens. Kaiser Family Foundation, 2017

Lack of access to health insurance and healthcare is a key issue for lawfully present and undocumented immigrants to the United States. However, immigrants also forego or miss out on treatment for mental illness as well as preventative care along with a number of other important facets of healthcare (RWFJ, 2018). Factors include: 

  • socioeconomic background
  • immigration status
  • language proficiencies
  • geographic location
  • fear of deportation

Children are particularly negatively affected by these factors, even if they are permanent citizens while their parents or relatives are not. In terms of outlook, it is possible that immigrant health care disparities will increase alongside diminishing coverage options, expanding cultural stressors, and cutbacks to community health centers and programs (KFF, 2017). The following list of resources covers all of these domains in order to give providers, communities, and policy makers information that can decrease the disparities faced by immigrants in the United States.

 Resources for immigrant populations 

 Disparities in Asian-American populations 

The Model-Minority Myth describes a pervasive misunderstanding that Asian Americans are more likely to succeed in most areas of American life, including healthcare. This has resulted in approaches to health and healthcare which play down and/or ignore Asian American healthcare needs and the disparities that arise from those needs. For instance, Asian Americans experience high rates of diabetes, stomach cancers, smoking-related illnesses, and mental health issues, while often failing to receive care in these areas (Trinh-Shevrin, 2017). In order to push back against the model-minority myth and the inequities that arise, it's important to consider the complex needs of Asian Americans. 

 Resources for Asian-American populations 

 Disparities in Black/African American Populations

Black Americans experience higher mortality rates than any other racial/ethnic group in the United States for 8 of the top 10 causes of death. (, 2015) And while overall health has improved among Black Americans in the past two decades, Growth is slower and often lacking when compared to the overall health of other racial/ethnic groups. (, 2018) Further, social constraints and inherent racism tied to poverty, incarceration, and geographical location often cause Black Americans (especially Black American men) to age at a more rapid pace than other Americans, which requires more extensive healthcare sooner in life and longer across the lifespan. Additionally, Black Americans are most likely to contract HIV/AIDS than other racial groups. It is imperative for providers, communities, and policy makers to not only push for increased literacy concerning each of these trends, but community organizations such as churches and cultural centers should be employed as allies that promote health literacy. Finally, healthcare disparities for Black Americans cannot be eliminated without changes to laws and organizational structures, which must be another priority, especially for policy makers and legislators.

 Information for Black/African Americans

 Disparities in Hispanic/Latinx Populations

Hispanic Americans, though the largest racial/ethnic minority in the United States, continue to experience "poor conditions of daily life, shaped by structural and social position factors (such as macroeconomics, cultural values, income, education, occupation, and social support systems, including health services)". (Velasco-Mondragon, et al., 2016) This conflux of forces results in higher likelihood to experience trauma, chronic stress/anxiety, sedentary behavior, and substance abuse, as well as lack of sleep. (Velasco-Mondragon, et al., 2016) These factors, along with higher risks for non-communicable diseases (arising from obesity, alcohol abuse, tobacco use, etc.) and lack of affordable healthcare and insurance, result in increased health and healthcare disparities for Hispanic Americans. Hispanic Americans are also more likely to experience healthcare needs that arise from occupation and geography, especially in farming and agricultural communities. For Hispanic American health, it is particularly important to target these societal and structural factors because compounded, they result in higher rates of diabetes, cardiovascular diseases, cancers, liver disease, and occupational injuries.

 Information for Hispanic/Latinx Americans

 Disparities in American Indian/Alaskan Native Populations

Health and healthcare disparities are ever-present and unyielding across many American Indian and Alaskan Native communities. Even as overall health has increased for much of the U.S. population, American Indian and Alaskan Natives continue to have lower life expectancy that is 5.5 years less than all other ethnic/racial groups in the United States. (, 2018) These rates are partially due to  American Indian and Alaskan Natives experiencing higher rates of liver disease, cirrhosis, diabetes, mental health, chronic trauma, unintentional injuries, assault, suicide, and lower respiratory diseases, compounded by a lack of access to healthcare and affordable coverage. (, 2018) Many of these epidemiologies are the result of social determinants produced by "structural violence" that "shapes the health" of  American Indian and Alaskan Natives and results in widespread inequities in housing, employment, food/water, transportation, and safety. (Browne, et al., 2016).

Providers, communities, and policy makers should take all of these factors into account when considering the health and healthcare of American Native populations.

 Resources for American Indian/Alaskan Native Populations