[health status of african americans in arkansas] · in addition, 34.3% of all african americans...

2012 University of Arkansas, College of Public Health –

Department of Epidemiology UAMS Prepared by: Jennifer Maulden, MA Melanie Goodell, MPH Martha M. Phillips, PhD, MPH, MBA

[HEALTH STATUS OF AFRICAN AMERICANS IN ARKANSAS]

PREPARATION OF THIS REPORT SUPPORTED BY: ARKANSAS MINORITY HEALTH COMMISSION

ARKANSAS CENTER FOR HEALTH DISPARITIES ARKANSAS PREVENTION RESEARCH CENTER

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The preparation of this report was supported in part by funding from the National Institute On Minority Health and Health Disparities of the National Institutes of Health (Grant # P20MD002329) and the Centers for Disease Control and Prevention (Cooperative Agreement # U48DP001943). The content is solely the responsibility of the authors and does not necessarily reflect the official views of the National Institutes of Health or the Centers for Disease Control and Prevention.

PhillipsMarthaM

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TABLE OF CONTENTS EXECUTIVE SUMMARY ............................................................................................................................... iv

INTRODUCTION ........................................................................................................................................... 1

Population Distribution ............................................................................................................................... 2

African-American Population in Arkansas by County ....................................................................... 3

DEMOGRAPHIC CHARACTERISTICS

Age (by Gender)

Median Age......................................................................................................................................... 5

Distribution ......................................................................................................................................... 5

Household and Families ............................................................................................................................... 6

SOCIO-ECONOMIC CHARACTERISTICS

Educational Attainment .............................................................................................................................. 8

Employment Status ..................................................................................................................................... 9

Civilian Employed: Population Over 16 Years of Age (Male & Female) ..................................................... 9

Income

Median ............................................................................................................................................... 10

Past 12 Months .................................................................................................................................. 10

Marital Status .............................................................................................................................................. 11

Poverty Level ............................................................................................................................................... 12

HEALTH STATUS

How is Your General Health ....................................................................................................................... 14

Health Status ............................................................................................................................................... 14

i

MORBIDITY

Asthma......................................................................................................................................................... 16

Diabetes ....................................................................................................................................................... 16

Heart Disease .............................................................................................................................................. 17

Hypertension ............................................................................................................................................... 18

Stroke .......................................................................................................................................................... 18

MORTALITY

All Causes .................................................................................................................................................... 20

Top Five Leading Causes of Death by Age Group ............................................................................ 21

Cancer, All .................................................................................................................................................. 22

Breast Cancer ................................................................................................................................... 22

Cervical Cancer ................................................................................................................................. 23

Colorectal Cancer ............................................................................................................................. 23

Lung Cancer ...................................................................................................................................... 24

Prostate Cancer ................................................................................................................................ 24

Heart Disease ............................................................................................................................................ 25

HIV/AIDS ..................................................................................................................................................... 25

Homicide ..................................................................................................................................................... 26

Motor Vehicle Accident ............................................................................................................................. 26

Stroke ......................................................................................................................................................... 27

Suicide ........................................................................................................................................................ 27

MATERNAL AND CHILD HEALTH

Births to Unmarried Mothers .................................................................................................................... 29

Infant Mortality ......................................................................................................................................... 29

HIV Testing During Pregnancy or Delivery ............................................................................................... 30

Live Births ................................................................................................................................................... 30

Low Birth Weight ....................................................................................................................................... 31

Mothers Who Smoked During Pregnancy ................................................................................................ 31

Physical Abuse ............................................................................................................................................ 32

ii

Prenatal Care, Inadequate ......................................................................................................................... 32

Teenage Pregnancy ................................................................................................................................... 33

Unmarried ........................................................................................................................................ 33

HEALTH PROTECTING / BEHAVIORAL RISK FACTORS

Age Appropriate Screening

Cholesterol Checks ........................................................................................................................... 35

Colorectal Screening ........................................................................................................................ 36

Mammograms .................................................................................................................................. 37

Pap Smears ....................................................................................................................................... 37

Alcohol Consumption ................................................................................................................................ 38

Fruit & Vegetable Intake ............................................................................................................................ 39

Oral Health ................................................................................................................................................. 39

Overweight & Obesity .............................................................................................................................. 40

Physical Activity........................................................................................................................................... 41

Tobacco Use ............................................................................................................................................... 42

ACCESS TO CARE

Healthcare Access / Coverage ................................................................................................................... 44

Medicaid ..................................................................................................................................................... 45

Medicare ..................................................................................................................................................... 45

APPENDIX AND REFERENCES

Appendix A: Glossary of Selected Terms .................................................................................................. 47 References ................................................................................................................................................. 48

iii

EXECUTIVE SUMMARY

This report presents data on demographic and socioeconomic characteristics, health status,

morbidity and mortality, maternal and child health, health protecting and behavioral risk

factors, and access to health care among African American/Black Arkansans in comparison

with White, non-Hispanic Arkansans.

KEY FINDINGS OF THIS REPORT

Education – Approximately 21.5% of African Americans 25 years of age and over had less than a high school education, compared to 14.2% of Whites; rates were similar between the two races for high school graduation.

Income – The median income of households in Arkansas was significantly lower for African Americans ($23,839) than for Whites ($41,343). In addition, 34.3% of all African Americans were in poverty, compared to 14.4% of Whites.

Morbidity – Over the past several years, African Americans were told they had asthma, diabetes, and hypertension at higher rates than Whites; conversely, Whites were told they had angina/heart disease and heart attack at higher rates.

Mortality – Mortality rates of African Americans were significantly higher than those of Whites for most cancers, HIV, and homicide, but lower for motor vehicle crashes and suicide.

Maternal and Child Health – HIV testing during pregnancy or delivery was higher for African Americans (64.7%) than for White women (55.6%), and a lower proportion of African American mothers reported smoking during pregnancy (12.5%) than did white mothers (29.7%). However, rates of unintended pregnancy, inadequate prenatal care, low birth weight, and infant mortality and were higher for African Americans than for Whites.

Behavioral Risk Factors – A higher proportion of African Americans were overweight or obese (82.7%) compared to Whites (66%).

Access to Care – While Whites made up 63% of Medicaid enrollees, nonelderly African Americans were more likely (26%) to have Medicaid coverage than were Whites (16%).

iv

INTRODUCTION

This report provides information about major health indicators for the African

American/black and white, non-Hispanic population of Arkansas. ‘African American/Black’ is

defined as a person having origins in any of the black racial groups of Africa. ‘White’ is

defined as a person having origins in any of the original peoples of Europe, the Middle East,

and North Africa. For the purposes of this report, ‘White’ does not include persons with

Hispanic or Latino heritage. Most data sources base race upon self-identification.

This report presents data on demographic and socio-economic characteristics, health status,

morbidity and mortality, maternal and child health, health protecting and behavioral risk

factors, and access to health care among African American/black Arkansans in comparison

with white, non-Hispanic Arkansans.

1

POPULATION DISTRIBUTION

As of July 1, 2010, Arkansas’ population was 2.9 million persons of whom 74.5% were white,

15.3% were African American, 6.4% were Latino, 1.2% were Asian, 0.7% were American Indian

and Alaska Native, and 0.2% were Native Hawaiian and Pacific Islander.1

The proportion of African Americans in Arkansas’ population decreased slightly from 2000 to

2010, falling from 15.7% (418,950 persons) to 15.3 % (447,102 persons). The African American

population in Arkansas is unequally distributed geographically. Together, five counties --

Crittenden, Jefferson, Mississippi, Pulaski, and St. Francis Counties—are home to more than

half of the African Americans who live in Arkansas. Conversely, some counties—for example,

Stone, Newton, Searcy, Baxter, Madison, and Marion—have very few African American

residents. The racial distribution of Arkansas follows a pattern in which the African American

population is concentrated toward the southeast portion of the state, while the northwest

portion of Arkansas is primarily White. 1

2

African American, Percent of County Population: 2010

(Source: U.S. Census Bureau, GCT-PL1)

3

DEMOGRAPHIC CHARACTERISTICS

Age (by Gender)

Median Age 5

Distribution

Household and Families 6

MEDIAN AGE

32.1 29.2

42.4 39.8

0

10

20

30

40

Females Males

African American White, non-Hispanic

Source: U.S. Census Bureau, Census 2010 Summary File (SF 1)

Median age is defined as one age that divides the population evenly. Half of the population is older and half is younger. If a population’s older adults outnumber its young children, the median age will be higher; if the young outnumber the old, the median age will be lower.3 The African American population in Arkansas trends younger in comparison to the white, non-Hispanic population.

AGE DISTRIBUTION

8.4% 17.1%

35.8%

40.5%

26.0%

21.0%

29.8% 21.4%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


Under 18 Years 18 to 34 Years 35 to 64 Years 65 Years and Over


5

HOUSEHOLDS AND FAMILIES

64.8%

27.4% 31.6%

35.2%

67.5%

53.5%

9.9%

32.5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Family Household Married-Couple Family Female Householder, No Husband Present, Family

Non-Family Households


In 2010, families made up only 64.8 % of households for African Americans, a proportion slightly smaller than

among white households (67.5%). There were fewer African American married-couple households (27.4%) than

white married-couple family households (53.5%) in Arkansas. Moreover, 31.6% of households for African

Americans in Arkansas were female householders with no husband present. This was much higher than white

female householders with no husband present (9.9%). Nonfamily households made up 35.2% of African

American and 32.5% of white households in Arkansas. Most of the nonfamily households were people living

alone, but some were composed of people living in households in which no one was related to the

householder. Average household size was similar for African Americans and Whites (2.5 and 2.4, respectively),

as was average family size (3.2 and 2.9, respectively).


6

SOCIO-ECONOMIC CHARACTERISTICS

Educational Attainment 8

Employment Status 9

Civilian Employed: Population 9 Income, Median Household 10

Income, Past 12 Months 10

Marital Status 11

Poverty Level 12

Families with Children

Under 18 Years

Population

EDUCATIONAL ATTAINMENT

Educational attainment refers to the highest level of education completed and is an indicator of the general level of education in a population. Generally, higher levels of education are positively associated with economic success and inversely associated with unemployment.5

High educational attainment has been linked to many positive health outcomes, such as higher life expectancy and better health quality for educated parents’ children. In addition, it leads to increased health knowledge, better working conditions, and increased social and economic resources.4

In 2010, approximately 22% of African American persons 25 years and over had less than a high school education. The proportions of African Americans and Whites that are high school graduates are similar.

In 2010, African Americans were less likely to have a bachelor’s degree (8.4%) or a graduate or professional degree (3.8%) than Whites (14.2% and 6.8%, respectively).

6.8%

14.2%

29.6%

35.1%

14.2%

3.8%

8.4%

29.0%

37.4%

21.5%

0% 10% 20% 30% 40% 50%

Graduate or Professional Degree

Bachelor's Degree

Some College or Assoicate Degree

High School Graduate (Includes Equivalency)

Less than High School

African American

White, non-Hispanic

Source: U.S. Census Bureau, 2010 American Community Survey, B15002H & B15002B.

Population Over 25 Years

“People with more education are more likely to live in health-promoting environments that encourage and enable them to

adopt and maintain healthy behaviors.”4 The Robert Wood Johnson Foundation

8

EMPLOYMENT STATUS

40.0% 40.4%

0.2% 0.3%

50.0% 54.4%

9.8% 4.8%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


Unemployed Employed Armed Forces Not in Labor Force

Population 16 Years and Over

6.6%

0.6%

0.1%

34.5%

19.6%

38.6%

11.6%

0.2%

0.3%

28.8%

28.7%

30.4%

0% 10% 20% 30% 40% 50%

Production, Transportation Material Moving

Construction, Extraction, Maintenance and Repair

Farming, Fishing, Forestry

Sales and Office

Service

Management, Professional and Related


22.1%

18.3%

2.3%

16.5%

12.4%

28.4%

34.0%

9.4%

2.2%

16.1%

21.7%

16.6%

0% 10% 20% 30% 40%

Production, Transportation Material Moving

Construction, Extraction, Maintenance and Repair

Farming, Fishing, Forestry

Sales and Office

Service

Management, Professional and Related


Male Civilian Employed: Population Over 16 Years of Age Female Civilian Employed: Population Over 16 Years of Age

Source: U.S. Census Bureau, 2010 American Community Survey, C23002B & C23002H.

9

Source: U.S. Census Bureau, 2010 American Community Survey, B24010H and B24010B

INCOME, MEDIAN*

Median income is a midpoint measure: half of incomes are above this value and half are below. 6 Median income of households in Arkansas was $23,839 for African Americans and $41,343 for Whites. For families, married-couples, and female householders (no husband present), median incomes were far lower for African Americans than Whites. * Income in the past 12 months (in 2009 inflation-adjusted dollars)

$25,476

$57,611

$51,047

$41,343

$16,765

$48,440

$27,025

$23,839

$0 $20,000 $40,000 $60,000 $80,000

Female Householder, no husband present

Married-Couple

Family

Household


INCOME, PAST 12 MONTHS*

$17,983

$2,939

$6,982

$15,082

$56,491

$12,798

$2,138

$6,665

$11,478

$33,933

$0 $10,000 $20,000 $30,000 $40,000 $50,000 $60,000

Retirement

Cash Public Assistance

Supplemental Security

Social Security

Earnings

African American White, non-Hispanics

Source: U.S. Census Bureau, 2009 American Community Survey Selected Population Profile, S0201

* Income in the past 12 months (in 2009 inflation-adjusted dollars)

Source: U.S. Census Bureau, 2009 American Community Survey Selected Population Profile, S0201

MARITAL STATUS

21.5%

2.1%

13.2%

7.9%

55.4%

44.7%

5.1%

13.9%

6.6%

29.7%

0% 10% 20% 30% 40% 50% 60%

Never Married

Separated

Divorced

Widowed

Now Married, except Separated

African American

White, non-Hispanic

18.3%

2.4%

13.8%

12.1%

53.4%

42.5%

5.7%

15.1%

9.9%

26.7%

0% 10% 20% 30% 40% 50% 60%

Never Married

Separated

Divorced

Widowed

Now Married, Except Separated


Source: U.S. Census Bureau, 2010 American Community Survey, B12002B and B12002H

25.0%

1.7%

12.5%

3.3%

57.4%

47.1%

4.5%

12.5%

2.8%

33.1%

0% 10% 20% 30% 40% 50% 60%

Never Married

Separated

Divorced

Widowed

Now Married, Except Separated


Males Females

Population 15 Years and Over

POVERTY LEVEL

8.9%

32.9%

5.4%

17.4%

10.3%

14.4%

22.8%

44.7%

13.1%

42.2%

30.7%

34.3%

0% 20% 40% 60%

65 Years and Over

Female Householder, No Husband Present, Family

Married-Couple Family

All Families with Related Children Under 18 Years

All Families

All People


The U.S. Census Bureau calculates poverty thresholds based on family size and the age of its members. Individuals or families are considered to be in poverty if all sources of income combined (excluding noncash benefits such as food stamps or housing subsidies) equal a value under this threshold.6

In 2010, the percentage of the population under the poverty threshold was higher among African Americans than among Whites. Among all persons, African Americans were more than twice as likely to live in poverty compared to their white counterparts. Furthermore, African American families and adults 65 years and older were more than twice as likely to live in poverty compared to white families. Forty-two percent of African American families with related children under 18 years lived below the poverty threshold, which was significantly higher compared to white families with related children under 18 years (17.4%).

Source: U.S. Census Bureau, 2010 American Community Survey, B17010H

“Economic research suggests that individuals living in poverty face an increased risk for adverse outcomes, such as poor health, criminal activity, and low participation in

the workforce.”7 U.S. Government Accountability Office

12

HEALTH STATUS

General Health 14

Health Status 14

\

GENERAL HEALTH /HEALTH STATUS

Studies have shown that self-reported general health questions can be a predictor of mortality. Generally, responses such as “poor” are associated with higher levels of mortality than responses of “very good” or “excellent.” General health questions can be useful because they assess not only current health status, but also perceived future health. In addition, they can help quantify aspects of health that cannot be measured by mortality and morbidity rates alone, and identify people with certain health needs.9 In 2010, when asked how their health was in general, 21.3% of African Americans reported that it was ‘excellent’ compared to 18.3% Whites. Another 23.4% of African Americans reported it was ‘very good’. In 2010, 75.8 % of African Americans reported ‘good or better health.’ However, 24.2% of African Americans rated their health as ‘fair or poor.’ This proportion was higher than that found among Whites (17.9%).

82.1%

17.9%

75.8%

24.2%

0% 20% 40% 60% 80% 100%

Good or Better Health

Fair or Poor Health

African American *White

Health Status

18.3%

31.9%

31.9%

12.3%

5.6%

21.3%

23.4%

31.1%

16.4%

7.8%

0% 5% 10% 15% 20% 25% 30% 35%

Excellent

Very Good

Good

Fair

Poor


General Health Status

Source: CDC, BRFSS, 2010 *Data available for white only

14

MORBIDITY

Asthma 16

Diabetes 16

Heart Disease 17

Hypertension 18

Stroke 18

ASTHMA Asthma is a chronic lung disease in which the airways constrict, making it difficult to breathe. This can lead to coughing, wheezing, chest tightness, and shortness of breath.11

From 2008 to 2010, a higher proportion of African Americans reported that they had previously been told they had asthma. In 2010, 14.0% of African American adults reported ‘ever been told they have asthma,’ compared to 13.3% of white adults.

14.5%

16.4%

14.0%

12.4% 11.2%

13.3%

0%

5%

10%

15%

20%

2008 2009 2010


DIABETES

Diabetes is a disease in which the body has difficulty producing and/or using insulin, causing high blood glucose levels. Type 1 diabetes is usually diagnosed at young ages; Type 2 is typically associated with factors such as obesity and physical inactivity, and is more common in certain populations, such as African Americans and the elderly.12

The prevalence of diabetes among African Americans in Arkansas has shifted over the past few years. In 2010, diabetes was more common among African American adults (11.6%) than among white adults (9.3%).

Adults Who Have Ever Been Told They Have Asthma

Source: CDC, BRFSS, 2008-2010 * Data for White only

11.5%

13.9%

11.6%

9.4% 9.3% 9.3%

0%

2%

4%

6%

8%

10%

12%

14%

16%

2008 2009 2010


Adults Who Have Ever Been Told They Have Diabetes


16

HEART DISEASE

Heart disease is a term which refers to multiple heart conditions. The most common heart disease in the United States is coronary heart disease, a condition in which plaque accumulates on the interior of arteries in the body, causing them to harden and narrow. A heart attack can occur if blood flow to the heart is blocked by this plaque build-up. Heart disease is the leading cause of death in the U.S., but risk can be lowered by controlling these risk factors: high cholesterol, high blood pressure, smoking, diabetes, overweight or obesity, physical inactivity, and unhealthy diet.11 From 2007 to 2008, the proportion of African Americans who had ever been told they had angina (chest pain) or coronary heart disease rose slightly (from 4.7% to 5.2%). However, in 2010 this proportion dropped to 1.8%. In all three years, African Americans were less likely to be told they had angina or coronary heart disease than were Whites.

Similarly, from 2008-2010, the number of African Americans who had ever been told they had had a heart attack decreased from 5.5% (2008) to 3.6% (2010). Whites reported similar rates, except in 2010 (5.2%).

4.7%

5.2%

1.8%

6.3% 6.0%

5.4%

0%

1%

2%

3%

4%

5%

6%

7%

2008 2009 2010


Ever Told Had Angina or Coronary Heart Disease

5.5%

5.0%

3.6%

5.4% 5.4% 5.2%

0%

1%

2%

3%

4%

5%

6%

2008 2009 2010


Ever Told Had a Heart Attack (Myocardial Infarction)



17

STROKE A stroke is the result of a blood flow interruption (e.g., due to a blood clot or artery rupture) which prevents blood flow to the brain. When brain cells die during a stroke due to the lack of oxygen, various problems can result depending on the part(s) of the brain affected, such as memory loss, speech complications, and paralysis.13 The proportion of African Americans who reported ever being told they had had a stroke spiked in 2009 at 7%, but dropped to 2.3% in 2010.

HYPERTENSION Blood pressure measures the force of the blood against artery walls as the heart pumps blood. Hypertension occurs when blood pressure is elevated for extended periods of time; it also increases the risk of heart disease.11

The proportion of African Americans who had ever been told they had high blood pressure rose from 37.5% in 2007 to 42.2% in 2009. For each recent year data is available (2005, 2007, & 2009), African Americans demonstrate a higher proportion than Whites on this health indicator.

39.4% 37.5%

42.2%

28.2%

31.3%

34.8%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

2005 2007 2009


Adults Who Have Been Told They Have High Blood Pressure

Source: CDC, BRFSS, 2005-2009 *Data for White only

3.1%

7.0%

2.3%

3.3% 3.4% 3.6%

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

8.0%

2008 2009 2010



Adults Who Have Ever Been Told They Had a Stroke

18

MORTALITY

All Causes 20

Leading Causes of Death by

Age Group 21

Cancer, All 22

Breast Cancer 22

Cervical Cancer 23

Colorectal Cancer 23 Lung Cancer 24 Prostate Cancer 24

Heart Disease 25

HIV/AIDS 25

Homicide 26

Motor Vehicle Accident 26

Stroke 27

Suicide 27

Ten Leading Causes of Death, All Ages, 2005-2009

361

471

509

594

641

886

1,003

1,392

4,154

4,914

0 1,000 2,000 3,000 4,000 5,000 6,000

10 Influenza & Pneumonia

09 Chronic Lower Resporatory Disease

08 Septicemia

07 Homicide

06 Nephritis

05 Unintentional Injury

04 Diabetes Mellitus

03 Cerebrovascular Disease

02 Malignant Neoplasms

01 Heart Disease

African American, both Sexes

1,978

2,544

3,224

3,534

3,701

5,926

7,531

7,912

27,463

31,771

0 5,000 10,000 15,000 20,000 25,000 30,000 35,000

10 Septicemia

09 Nephritis

08 Diabetes Mellitus

07 Influenza & Pneumonia

06 Alzheimer's Disease

05 Unintentional Injury

04 Cerebrovascular Disease

03 Chronic Lower Respiratory Disease

02 Malignant Neoplasms

01 Heart Disease

White, non-Hispanic, both Sexes

ALL CAUSES Source: CDC Web-based Injury Statistics Query and Reporting System (WISQARS).

20

LEADING CAUSES OF DEATH (AGE GROUP)

Top Five Leading Causes of Death 2005-2009 Children, Adolescents, and Young Adults

(African American)

CHILDREN AGES 1-14 YEARS 1. Unintentional Injury (motor vehicle traffic, fire/burn, drowning & other) 2. Homicide (unspecified, firearm & other) 3. Heart Disease 4. Cancer 5. Congenital Anomalies

ADOLESCENTS AGES 15-19 YEARS 1. Unintentional Injury (motor vehicle traffic, drowning & other) 2. Homicide (firearm, cut/pierce & other) 3. Suicide (firearm & suffocation) 4. Congenital Anomalies 5. Heart Disease

YOUNG ADULTS AGES 20-44 YEARS 1. Homicide (firearm, cut/pierce & other) 2. Heart Disease 3. Unintentional Injury (motor vehicle traffic, fire/burn & other) 4. Cancer 5. HIV

MIDDLE-AGED ADULTS 45-64 YEARS 1. Cancer 2. Heart Disease 3. Cerebrovascular Disease or Stroke 4. Diabetes Mellitus 5. Unintentional Injury (motor vehicle traffic, fire/burn & other)

ADULTS 65 YEARS AND OLDER 1. Heart Disease 2. Cancer 3. Cerebrovascular Disease or Stroke 4. Diabetes Mellitus 5. Nephritis

Source: CDC Web-based Injury Statistics Query and Reporting System (WISQARS). Top Five Leading Causes of Death 2005-2009

Children, Adolescents, and Young Adults (White, non-Hispanic)

CHILDREN AGES 1-14 YEARS 1. Unintentional Injury (motor vehicle traffic, drowning, fire/burn & other) 2. Cancer 3. Heart Disease 4. Congenital Anomalies 5. Homicides (firearm & unspecified)

ADOLESCENTS AGES 15-19 YEARS 1. Unintentional Injury (motor vehicle traffic, drowning & other) 2. Suicide (firearm, suffocation & other) 3. Homicide (firearm, suffocation & other) 4. Heart Disease 5. Cancer

YOUNG ADULTS AGES 20-44 YEARS 1. Unintentional Injury (motor vehicle traffic, poisoning & other) 2. Heart Disease 3. Suicide (firearm, suffocation & other) 4. Cancer 5. Homicide (firearm, cut/pierce & other)

MIDDLE-AGED ADULTS 45-64 YEARS 1. Cancer 2. Heart Disease 3. Unintentional Injury (motor vehicle traffic, poisoning & other) 4. Chronic Lower Respiratory Disease 5. Diabetes Mellitus

ADULTS 65 YEARS AND OLDER 1. Heart Disease 2. Cancer 3. Chronic Lower Respiratory Disease 4. Cerebrovascular Disease or Stroke 5. Alzheimer’s Disease

21

ALL CANCER

Breast cancer forms in breast tissues and may spread to other parts of the body. Given current trends, it is estimated that 1 in 8 women born now will be diagnosed with breast cancer at some point in their lives. Risk factors for breast cancer include older age, excessive alcohol use, family history, race, and lack of physical activity.14

In 2008, age-adjusted death rate for all cancer sites combined was substantially higher for African Americans (250.2 per 100,000) than for Whites (197.3 per 100,000). According to Arkansas’ Healthy People 2020 Health Status Report,10 the state goal is to lower cancer mortality rates to 160 cancer deaths per 100,000 persons per year.

In 2008, age-adjusted death rate for breast cancer was higher among African American females (27.6 per 100,000) compared to white females (20.7 per 100,000).

BREAST CANCER

Cancer refers to a group of diseases involving the uncontrollable growth and spread of abnormal cells in the body. These diseases can result in death if the growth isn’t controlled. Risk factors vary by cancer type, but the most common are older age, tobacco use, sunlight, radiation, poor nutrition, physical inactivity, and obesity. The most commonly diagnosed cancers include those of the bladder, breast, colon/rectal, and lung.14

250.2

197.3

0

50

100

150

200

250

300


Rate per 100,000 people per year

27.6

20.7

0

10

20

30


Rate per 100,000 females per year

Source: CDC Wonder Online Database, 2008


22

CERVICAL CANCER Cervical cancer forms in the tissues of the cervix, and is usually caused by human papillomavirus (HPV). Because it is a slow-growing cancer, it can usually be found with regular pap tests, making these screenings essential to prevention. The risk of cervical cancer is increased by: 14

• HPV infection • smoking • long term use of oral

contraceptives • high number of full-term

pregnancies (7+)

COLORECTAL CANCER

Colorectal cancer forms in the colon or the rectum, the two organs which form the large intestine. Experts recommend screenings for colorectal cancer for people aged 50 and older. Risk factors for colorectal cancer include:14

• Age (50+) • colorectal polyps • family history of cancer • personal history of cancer • ulcerative colitis or Crohn’s

disease • smoking

In 2008, age-adjusted death rate for colorectal cancer was significantly higher among African Americans (29.5 per 100,000) than among Whites (18.7 per 100,000). According to Arkansas’ Healthy People 2020 Health Status Report,10 the goal is 14.5 colorectal cancer deaths 100,000 persons per year.

5.2

2.9

0

1

2

3

4

5

6


Rate per 100,000 females per year

Source: CDC Wonder Online Database, 2007-2008

29.5

18.7

0

10

20

30

40




In 2007-2008, age-adjusted death rate for cervical cancer was greater among African American females (5.3 per 100,000) than among white females (2.9 per 100,000). According to Arkansas’ Healthy People 2020 Health Status Report,10 the goal is 2 uterine cervix deaths 100,000 persons per year.

23

PROSTATE CANCER

LUNG CANCER

In 2008, the age-adjusted death rate from prostate cancer among African American males (55.4 deaths per 100,000) was more than twice the rate among white males (20.2 deaths per 100,000).

Lung cancer forms in the lungs but, like other types of cancer, may spread to other parts of the body. Cigarette smoking is the most common cause of lung cancer. Symptoms include persistent cough, difficulty breathing, constant chest pain, fatigue, unexplained weight loss, and coughing up blood.14

In 2008, rates for lung cancer deaths were similar for African Americans and Whites.

Prostate cancer forms in the tissues of the prostate, a gland in the male reproductive system. Prostate cancer is the second most common cancer in men in the United States. Prostate cancer is more common among African American men than among white men. Risk factors for prostate cancer include:14

• age (65+) • family history • race

71.3 68.9

0

20

40

60

80

African American

White, non-Hispanic



55.4

20.2

0

10

20

30

40

50

60



Rate per 100,000 males per year

24

HIV

Heart disease is the number one cause of death for both men and women in America. In 2008, it was responsible for almost a quarter of all deaths in the United States. Heart disease can lead to further complications, such as heart attack, heart failure or arrhythmia.11

In 2008, age-adjusted death rate for HIV was considerably higher for African Americans (7.6 per 100,000) than for Whites (1.5 per 100,000). According to Arkansas’ Healthy People 2020 Health Status Report,10 the goal is 3.3 HIV infection deaths per 100,000 persons per year.

In 2008, age-adjusted death rate for heart disease was significantly higher for African Americans (272.7 deaths per 100,000) than for Whites (224.9 per 100,000).

HIV, or human immunodeficiency virus, is a devastating disease which attacks the body’s immune system. These attacks result in an increased risk of contracting other illnesses, such as pneumonia or tuberculosis. It is estimated that about 21% of the 1.1 million Americans living with HIV don’t know they’re infected with the virus. Modern treatments can suppress the virus, but there is currently no cure. In the U.S., HIV disproportionately affects African Americans. 15

HEART DISEASE

272.7

224.9

0

50

100

150

200

250

300

African American White, non-Hispanic Source: CDC Wonder Online Database, 2008


7.6

1.5

0

1

2

3

4

5

6

7

8

African American

White, non-Hispanic



25

HOMICIDE

MOTOR VEHICLE ACCIDENTS

In 2008, age-adjusted death rate for homicide was substantially higher among African Americans (21.0 per 100,000) than for Whites (5.0 per 100,000).

In 2009, the age-adjusted death rate for motor vehicle accidents (MVA) was lower for African Americans (18.8 per 100,000) than for Whites (24.0 per 100,000).

Homicide refers to willful killing of another human being. Statistics generally don’t include negligent manslaughter, accidents, or suicides. Nationally, African Americans are disproportionately affected by homicide: though they made up only 12% of the U.S. population from 1980 – 2008, they were victims in 47% of the homicides occurring during the same time period.16

The national Healthy People 2020 goal is to reduce homicides to 5.5 deaths per 100,000 people.8

21.0

5.0

0

5

10

15

20

25

30

African American

White, non-Hispanic

19.2

24.2

0.0

5.0

10.0

15.0

20.0

25.0

30.0

African American

White, non-Hispanic



Nationwide, motor vehicle crashes are the leading cause of death among people 5-34. In addition, motor vehicle crash fatalities per mile traveled increase dramatically after age 75. Ways to prevent motor vehicle fatalities include:17

• increasing seat belt use • deterring impaired driving • reducing distracted driving

According to Arkansas’ Healthy People 2020 Health Status Report,10

the goal is 12.4 MVA deaths per 100,000 people per year.



26

STROKE

SUICIDE Suicide is a complex public health issue with many underlying causes. Generally, African Americans tend to have lower suicide rates compared to Whites.

Common risk factors include: 19 • Depression • Prior attempt(s) • Personal/family history of

mental illness, substance abuse, or suicide

• Family violence

The national Healthy People 2020 goal is to reduce suicide deaths to 10.2 per 100,000 people.8

About 800,000 people have a stroke annually in the U.S. Even when strokes aren’t fatal, they can result in serious disability. African Americans, on average, are twice as likely as Whites to suffer a stroke. In addition, they are more likely to die from a stroke. Early detection is essential in the survival of a stroke: the most common symptom noticed by sufferers is sudden numbness on one side of the body.18

In 2008, age-adjusted death rate for stroke was significantly higher for African Americans (71.6 per 100,000) than for Whites (50.1 per 100,000). The Arkansas’ Healthy People 2020 Health Status Report goal is to reduce stroke deaths to 33.8 per 100,000 people.10

In 2008, age-adjusted death rate for suicide was far less for African Americans (5.3 per 100,000) in comparison to Whites (18.5 per 100,000).

71.6

50.1

0

10

20

30

40

50

60

70

80

African American

White, non-Hispanics



5.3

18.5

0

2

4

6

8

10

12

14

16

18

20

African American

White, non-Hispanic



27

MATERNAL AND CHILD HEALTH

Births to Unmarried Mothers 29

Infant Mortality 29

HIV Testing During Pregnancy or

Delivery 30

Live Births 30

Low Birth Weight 31

Mothers Who Smoked During

Pregnancy 31

Physical Abuse 32

Prenatal Care, Inadequate 32

Teenage Pregnancy 33

BIRTHS TO UNMARRIED MOTHERS

INFANT MORTALITY

Infant mortality refers to deaths of infants less than one year of age. In 2007, the rate for infant mortality among African Americans was 2.4 times higher than the rate among Whites nationally. Common causes of infant mortality include:22

• prematurity • sudden infant death

syndrome (SIDS) • congenital malformations • unintentional injury

In 2009, 41% of births in Arkansas were to unmarried women. Nationally, rates of births to unmarried mothers are higher among African Americans than among Whites.20

Births to unmarried mothers have been linked to:21

• Low birthweight • preterm birth • infant mortality • higher poverty rates

In 2009, 82% of all African American births were to unmarried mothers, a significantly higher proportion than among Whites (35%).

Infant mortality rate (per 1,000 live births) was substantially higher among African Americans (13.1) than Whites (6.9) in 2007. According to Arkansas’ Healthy People 2020 Health Status Report,10

the objective goal is 4.5 infant deaths per 1,000 live births.

82%

35%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

African American

White

Source: CDC, 2009 Birth Report

13.1

6.9

0

2

4

6

8

10

12

14

African American

White


Rate per 1,000 live births

29

HIV TESTING DURING PREGNANCY OR DELIVERY

LIVE BIRTHS

A live birth is formally described as a birth in which the infant shows any sign of life, including breath, heart rate, or movement.25

According to the CDC, over 4.1 million births were reported in the United States in 2009. In Arkansas, 39,808 births were reported in 2009.20

Maternal HIV testing is recommended for all mothers, regardless of whether they believe they’re infected with the virus. Testing is an important aspect of prenatal care, and can result in medications that can prevent passing the virus on to the infant. HIV-positive mothers who receive no interventions pass the virus to their baby up to 25% of the time, but with treatment, this proportion can be as low as 1-2%.24

In 2009, 19.2% of Arkansas live births were to African American women.

19.1%

26.6%

64.7%

55.6%

0%

10%

20%

30%

40%

50%

60%

70%

African American White

No

Yes

Source: CDC, PRAMS: CPONDER, 2008

In 2008, 64.7% of African American pregnant women reported having a HIV test during pregnancy or delivery, substantially higher than the percentage found among white pregnant women.

19.2%

67.8%

0%

10%

20%

30%

40%

50%

60%

70%

80%

African American

*White


30

LOW BIRTH WEIGHT

MOTHERS WHO SMOKED DURING PREGNANCY

Infants born weighing less than 2,500 grams (5 lbs., 8 oz.) are considered low birth weight. Most infants born at low birth weight are also premature (born before 37 weeks). Low birth weight infants have a higher risk of death and long term health problems than those born at healthy weights. Nationally, rates of low birth weight are higher among African Americans than among Whites.26

In addition to harming themselves, mothers who smoke during pregnancy put their unborn babies at risk as well. Smoking during pregnancy has been linked to multiple health problems, including:27

• preterm birth • low birth weight • SIDS • certain birth defects (e.g.,

cleft palate)

29.7% 12.5%

70.3% 87.5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

White African American

No

Yes


In 2009, 14.8% of infants born to African American mothers were classified as low birth weight, compared to 7.6% of infants born to white mothers.

In 2008, a lower proportion of African American mothers reported smoking during the last three months of pregnancy (12.5%) than did white mothers (29.7%).

14.8%

7.6%

0%

2%

4%

6%

8%

10%

12%

14%

16%

African American

White


31

4.3 2.4

95.7 97.6

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


No

Yes

PHYSICAL ABUSE

INADEQUATE PRENATAL CARE

Prenatal care is described as inadequate when it doesn’t begin until after the 4th month of pregnancy, and/or when mothers attend less than 50% of the recommended doctor visits.29 Infants born to mothers who received inadequate prenatal care are at increased risk of low birth weight and prematurity. Factors associated with inadequate prenatal care include:30

• poverty • pregnancy denial or apathy • lack of transportation • low maternal education

levels

Physical abuse during pregnancy puts both the mother and unborn child at risk. Physical abuse during pregnancy can lead to:28

• miscarriage • vaginal bleeding • premature birth • low birth weight

In Arkansas from 2006-2008, African American mothers were, on average, less likely to get adequate prenatal care than white mothers.

20.0%

11.9%

0%

5%

10%

15%

20%

25%

African American

*White

Source: March of Dimes, PeriStats

Percent of Live Births


*Data available for White only

Mothers who reported being physically hurt by their husband or partner in any way during their most recent pregnancy

32

TEENAGE PREGNANCY Source: CDC Wonder Online Database, 2009

8.8%

0.1%

4.2%

0.1%

0% 2% 4% 6% 8% 10%

15-19 Years of Age

< 15 Years of Age


UNINTENDED PREGNANCY

52.1%

28.4%

47.9%

71.6%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

White African American

Unintended

Intended

33

An unintended pregnancy is one that the mother describes as either unwanted or mistimed.8 Nationally, almost half of pregnancies are unintended. The rate for Arkansas is slightly higher, with 56% of pregnancies unintended in 2006.36

Unintended pregnancies are associated with several negative outcomes, including delay of prenatal care and maternal depression. These infants are more likely to be born with birth defects and low birth weight, and have behavioral or emotional problems as they grow.8

In 2008, the percentage of mothers who described their pregnancies as unintended was significantly higher for African American mothers (71.6%) than for white mothers (47.9%).

Source: CDC PRAMS: CPONDER, 2008

HEALTH PROTECTING / BEHAVIORAL RISK FACTORS

Age-Appropriate Screening

Cholesterol Checks 35

Colorectal Screening 36

Mammograms 37

Pap Smears 37

Alcohol Consumption 38

Fruit & Vegetable Intake 39

Oral Health 39

Overweight & Obesity 40

Physical Activity 41

Tobacco Use 42

TeamViewer 3.lnk

80.2%

78.3%

19.8%

21.7%

0% 50% 100%

*White

African American

Yes

No

CHOLESTEROL CHECK

Cholesterol checks are important for determining the level of cholesterol in the blood; high blood cholesterol leads to increased risk of coronary heart disease, heart attack, and stroke. Because people with high blood cholesterol frequently show no symptoms, it is recommended that adults have their cholesterol levels checked at least once every five years.11

According to Arkansas’ Healthy People 2020 Health Status Report,10

the goal is to have 82.1% of adults reporting having their blood cholesterol checked within the last 5 years. In 2009, the percentage of African Americans reporting ever having their cholesterol checked was 78.3%. When asked whether they had their cholesterol checked during the past five years, 76.7% of African Americans reported having it checked. Of respondents who had their cholesterol checked, 39.4% of African Americans reported they had been told it was high in 2009.

75.0%

5.0%

20.0%

76.7%

1.5%

21.8%

0% 20% 40% 60% 80% 100%

Checked in Past 5 Years

Not Checked in Past 5 Years

Never Checked

African American

*White

39.0%

39.4%

61.0%

60.6%

0% 20% 40% 60% 80% 100%

*White

African American

Yes

No

Source: Source: CDC, BRFSS, 2009 *Data available for White only

Adults Who Have Had Their Blood Cholesterol Checked and Have Been Told It Was High

Adults Who Have Had Their Blood Cholesterol Checked within the Last 5 Years

Adults Who Have Ever Had Their Blood Cholesterol Checked

35

13.6% 17.8%

86.4% 82.2%

0

20

40

60

80

100

African Americans *White

No

Yes

51.6% 62.6%

48.4% 37.4%

0

20

40

60

80

100


No

Yes

COLORECTAL SCREENING

Colorectal cancer usually begins with precancerous polyps in the colon or rectum. Therefore, screening is essential to detect and remove these polyps before they develop into cancer. The following screening tests are recommended after age 50:2 • Fecal Occult Blood Test

(FOBT): This screening uses either chemicals or antibodies to detect blood in the stool; a kit is provided for a sample to be collected at home, and the samples are sent to a lab for analysis. Recommended yearly.

• Flexible Sigmoidoscopy: A doctor uses a thin, flexible lighted tube inserted into the rectum to check for polyps or cancer that may be inside it or the lower portion of the colon. Recommended every 5 years.

• Colonoscopy: Similar to sigmoidoscopy but with a longer tube, the doctor checks for polyps or cancer inside the rectum and the entire colon. This test also allows the doctor to remove most polyps and cancers, and can be used as a follow-up test for unusual results of another screening test. Recommended every 10 years.

Adults Aged 50+ Who Have Had a Blood Test within the Past Two Years


Adults Aged 50+ Who Have Ever Had a Sigmoidoscopy or Colonoscopy

In 2010, 86.4% of African Americans 50 years old or older reported not having a fecal occult blood test within the past 2 years.

In 2010, 48.4% of African American adults 50+ reported not ever having a sigmoidoscopy or colonoscopy screening test.

36

PAP SMEARS

MAMMOGRAMS

During a pap smear, cells from the cervix are collected and then analyzed by a lab. Cervical cancer can be prevented if abnormal cells are found early and treated. Experts recommend a pap smear every 1-3 years, beginning at age 21 or 3 years after the beginning of sexual activity (whichever comes first).14 According to Arkansas’ Healthy People 2020 Health Status Report,10 the goal is for 93% of women 18 years of age an older to have a pap smear within the past 3 years.

A mammogram is a breast x-ray used to detect tumors that may be too small to feel; early detection is the key to preventing breast cancer from spreading. Doctors recommend women aged 40 and over have mammograms every 1-2 years.14 In 2010, 73.5% of African American women aged 40+ and 79.4% of African American women aged 50+ had a screening mammogram within the past two years.

73.5% 79.4%

68.8% 72.6%

0%

20%

40%

60%

80%

Aged 40+ 'Yes' Aged 50+ 'Yes'


Women Who Have Had a Mammogram within the Past 2 Years


79.8% 87.4%

20.2% 12.6%

0%

20%

40%

60%

80%

100%


No Yes

Women Aged 18+ Who Have Had a Pap Test within the Past 3 Years

Source: Source: CDC, BRFSS, 2008


37

ALCOHOL CONSUMPTION

Those who drink alcohol in moderation are less likely to develop alcohol dependence. In addition, drinking moderate amounts of certain types of alcohol may lower the risk of certain diseases, such as coronary heart disease. Drinking too much, however, has numerous effects on various parts of the body, such as the brain, heart, liver, pancreas, and immune system.31 In 2010, 40.7% of African American adults reported that they had at least one drink of alcohol in the past 30 days. In 2010, about 5.7% African American adults identified themselves as binge drinkers, significantly less than white adults (12.4%). Fewer African American adults (2.3%) identified themselves as heavy drinkers compared to white adults (4%).

89.7%

94.3%

12.4%

5.7%

0% 20% 40% 60% 80% 100%

*White

African American

No

Yes

Binge Drinkers (Males Having Five or More Drinks on One occasion, Females Having Four or More Drinks on One Occasion)

61.7%

59.3%

38.3%

40.7%

0% 20% 40% 60% 80% 100%

*White

African American

No

Yes

Adults Who Have Had at Least One Drink of Alcohol within the Past 30 Days


96.0%

97.7%

4.0%

2.3%

0% 20% 40% 60% 80% 100%

*White

African American

No

Yes

Heavy Drinkers (Adult Men Having More Than Two Drinks per Day and Adult Women Having More Than One Drink per Day)

38

FRUIT AND VEGETABLE INTAKE

Fruits and vegetables are recommended for their nutrients (such as potassium, vitamin C, and folic acid) and fiber. Diets high in fruits and vegetables can reduce the risk of adverse health conditions such as heart disease, heart attack, obesity, diabetes, and some cancers. Experts recommend that adults consume around 2 cups of fruit and 2-3 cups of vegetables daily.32

In 2009, African Americans were slightly less likely than Whites to eat fruits and vegetables five or more times per day.

20.2%

79.8%

18.7%

81.3%

0% 20% 40% 60% 80% 100%

Consumed 5 or More Times per Day

Consumed Less than 5 Times per Day



Adults Who Have Consumed Fruits and Vegetables Five or More Times per Day

ORAL HEALTH

Oral health is an essential component of overall health, and poor oral health can greatly reduce one’s quality of life.33 In 2010, African American adults (60.4%) were more likely than white adults (53.9%) to have had any permanent teeth extracted.

The national Healthy People 2020 objective is to reduce the proportion of adults who have ever had a permanent tooth extracted because of dental caries or periodontal disease to 68.8%.8

46.1%

39.6%

53.9%

60.4%

0% 20% 40% 60% 80% 100%

*White

African American

No

Yes

Adults Who Have Had Any Permanent Teeth Extracted

62.5%

55.9%

37.5%

44.1%

0% 20% 40% 60% 80% 100%

*White

African American

Yes

No

Visited the Dentist or Dental Clinic within the Past Year for Any Reason



39

OVERWEIGHT AND OBESITY

Overweight and obesity are serious health conditions that increase the risk of conditions such as coronary heart disease, high blood pressure, diabetes, and certain cancers. Nationally, about two-thirds of Americans are either overweight or obese. Over the past 30 years, children have also shown higher rates of overweight and obesity.11 The national Healthy People 2020 objective calls for increasing the prevalence of healthy weight to 30.8% among adults age 20 years and older.8

In 2010, African American adults were more likely to be obese (44.5%) compared to white adults (30.0%).

*BMI - An estimate of an individual’s relative body fat calculated from his or her height and weight.23

34.0%

17.3%

36.0%

38.2%

30.0%

44.5%

0% 20% 40% 60% 80% 100%

*White

African American

Neither Overweight nor Obese Overweight Obese


Weight Classification by Body Mass Index (BMI)*

“Overweight results when a person eats more calories from food (energy) than he or she expends, for

example, through physical activity. This balance between energy intake and output is influenced by

metabolic and genetic factors as well as behaviors affecting dietary intake and physical activity;

environmental, cultural, and socioeconomic components also play a role….Establishing healthful

dietary and physical activity behaviors needs to begin in childhood. Educating school-aged children

about nutrition is important to help establish healthful eating habits early in life.”23

Centers for Disease Control and Prevention, Healthy People 2010

40

PHYSICAL ACTIVITY

Physical activity is an important component in health and wellness, as well as a key to maintaining a healthy weight. For adults, experts recommend at least 2.5 hours of moderate physical activity (brisk walking, gardening, bicycling, canoeing, etc.) or 1.25 hours of vigorous physical activity (running/jogging, heavy yard work, swimming, aerobics, etc.) a week; for children, 1 hour of any type of physical activity a day is recommended. Regular physical activity provides many benefits, such as increased life expectancy, higher self-confidence, stronger muscles, and decreased risk of depression. Conversely, a lack of regular physical activity has been linked with a higher risk for heart disease, type 2 diabetes, high blood pressure, and stroke.32 In 2009, African American adults (73.6%) were more likely to be physically inactive compared to white adults (75.3%).

26.4% 24.7%

73.6% 75.3%

0%

20%

40%

60%

80%

100%


No

Yes

Adults with 20+ Minutes of Vigorous Physical Activity Three or More Days per Week

45.2% 47.5%

54.8% 52.5%

0%

20%

40%

60%

80%

100%


No

Yes


Adults with 30+ Minutes of Moderate Physical Activity Five or More Days a Week, or Vigorous Physical Activity for 20+ Minutes Three

or More Days per Week

41

TOBACCO

Tobacco use causes about 1 in 5 U.S. deaths and is the leading preventable cause of death in the country. In addition, about 50,000 nonsmokers die every year due to secondhand smoke exposure. Cigarette smoking causes about a third of all cancers and 90% of lung cancers. Smoking also increases the risk of conditions such as:

• heart disease • stroke • emphysema • chronic bronchitis

Tobacco addiction can be treated with behavioral treatments, nicotine replacement therapies, and/or medication.34 The national Healthy People 2020 goal calls for reducing the percentage of smokers to 12%.8 In 2010, rates for smoking were similar among African American and white adults. In addition, a higher percentage of African Americans reported never smoking.

77.9% 77.4%

22.1% 22.6%

0%

20%

40%

60%

80%

100%


Yes

No


Adults Who are Current Smokers

63.4 52.0

14.5% 25.5%

9.6% 4.9%

12.5% 17.7%

0%

20%

40%

60%

80%

100%


Smoke Everyday Smoke Some Days Former Smoker Never Smoked

42

ACCESS TO CARE

Healthcare Access / Coverage 44

Medicaid 45

Medicare 45

28.0%

19.7%

0%

10%

20%

30%

40%

African Americana *White

30.7%

24.7%

0%

10%

20%

30%

40%


HEALTHCARE ACCESS/ COVERAGE

Access to health care strongly impacts overall quality of life and life expectancy. Those with access to care enjoy benefits such as prevention of disease through early screening and more efficient treatment of existing medical conditions. Conversely, those who are unable to afford or access health care face outcomes such as preventable hospitalizations, unmet health needs, and delays in receiving care. One barrier that prevents many Americans from access to health care is a lack of health insurance coverage. When people don’t have medical insurance, they frequently postpone treatment; when they do seek treatment, they are burdened with costly medical bills. The national Healthy People 2020 goals for health insurance coverage are to see all people be covered by some form of health insurance.8 In 2010, 28.0% of African Americans were uninsured, significantly higher than the uninsured rate among Whites (19.7%).

‘No’ Health Care Coverage of Any Kind, Adults 18+ Years

Adults Aged 18-64 Years Who Reported ‘No’ to Having Any Kind of Heath Care Coverage


44

MEDICAID

Medicaid is a joint state-federal health insurance program which provides coverage to various categories of low income individuals and families. Medicaid covers various aspects of medical care such as doctor visits and prescription drugs.35 African Americans (26%) were more likely than Whites (16%) to have Medicaid coverage in 2009-2010. Though African Americans account for only 15.3% of Arkansas’ population, they represent 23% of Medicaid enrollees.

23%

63%

0%

20%

40%

60%

80%


Distribution of the Nonelderly with Medicaid

MEDICARE

Medicare is a federal health insurance program for people who are 65 and older or have certain disabilities and conditions. Medicare provides hospital and medical insurance, as well as prescription drug coverage.35

In Arkansas in 2007, on average, individual reimbursements for African American enrollees were about 26% higher than for non-African American enrollees.

$9,799

$7,745

$0.00

$2,000.00

$4,000.00

$6,000.00

$8,000.00

$10,000.00

$12,000.00

African American Non-African American

Demographic Characteristics of Medicaid Enrollees

Source: The Kaiser Family Foundation, 2009-2010 *Data available for White only

26%

16%

0%

10%

20%

30%

40%


Percent of People Covered by Medicaid, by Race

Source: Dartmouth Atlas of Health Care, 2007

Medicare Reimbursements per Enrollee

REFERENCES

1. U.S. Census Bureau (2010). American FactFinder. Retrieved May 29, 2012, from http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml

2. Centers for Disease Control and Prevention. (2012). Colorectal cancer: Screening saves lives. Retrieved June 5, 2012 from http://www.cdc.gov/cancer/colorectal/basic_info/screening/

3. Population Reference Bureau. (2004). Glossary of terms. Retrieved June 25, 2012 from http://www.prb.org/educators/resources/glossary.aspx

4. Robert Wood Johnson Foundation. (2011). Issue brief series: Exploring the social determinants of health education and health. Retrieved June 25, 2012 from www.health.wyo.gov/Media.aspx?mediaId=11376

5. U.S. Census Bureau. (2012). Educational attainment in the United States: 2009. Retrieved June 6, 2012 from http://www.census.gov/prod/2012pubs/p20-566.pdf

6. U.S. Census Bureau. (2011). How the Census Bureau measures poverty. Retrieved June 6, 2012 from http://www.census.gov/hhes/www/poverty/about/overview/measure.html

7. U.S. Government Accountability Office (2007). Poverty in America. Retrieved June 6, 2012 from http://www.gao.gov/new.items/d07344.pdf

8. U.S. Department of Health and Human Services (2012). Healthy people 2020: Topics and objectives index. Retrieved May 29, 2012 from http://www.healthypeople.gov/2020/topicsobjectives2020/default.aspx

9. DeSalvo, K. B., Bloser, N., Reynolds, K., He, J., & Muntner, P. (2006). Mortality prediction with a single general self-rated health question. Journal of General Internal Medicine, 21(3): 267-275.

10. Phillips, M. M., Quick, S., & Goodell, M. (2012). Arkansas Healthy People 2020 Health Status Report. Retrieved May 29, 2012 from http://www.uams.edu/phacs/reports/Healthy%20People%202020%20Status%20Report%20Apr%203%202012.pdf

11. National Heart Lung and Blood Institute (2012). Health topics. Retrieved June 6, 2012 from http://www.nhlbi.nih.gov/health/health-topics/by-category/

12. National Diabetes Information Clearinghouse. (2012). Diabetes overview. Retrieved June 7, 2012 from http://diabetes.niddk.nih.gov/dm/pubs/overview/index.aspx#what

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16. Cooper, A., & Smith, E. L., (2011). Homicide trends in the United States, 1980 – 2008. U.S. Department of Justice, Bureau of Justice Statistics. Retrieved June 11, 2012 from http://www.bjs.gov/content/pub/pdf/htus8008.pdf

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20. Martin, J. A., Hamilton, B. E., Ventura, S. J., Osterman, M. J. K., Kirmeyer, S., Mathews, T. J., & Wilson, E. (2011). Births: Final data for 2009. National Vital Statistics Reports, 60(1). Retrieved June 13, 2012 from http://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdf

21. Ventura, S. J. (2009). Changing patterns of nonmarital childbearing in the United States. Division of Vital Statistics. Retrieved June 12, 2012 from http://www.cdc.gov/nchs/data/databriefs/db18.htm#ref1

22. MacDorman, M. F., and Mathews, T. J. (2011). Understanding racial and ethnic disparities in U.S. infant mortality rates. Retrieved June 13, 2012 from http://www.cdc.gov/nchs/data/databriefs/db74.pdf

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24. Burr, C. K. (2011). Reducing maternal-infant HIV transmission. Retrieved June 13, 2012 from http://hab.hrsa.gov/deliverhivaidscare/clinicalguide11/cg-402_pmtct.html

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national indicators of well-being, 2011. Retrieved June 20, 2012 from http://www.childstats.gov/americaschildren/index.asp

27. Centers for Disease Control and Prevention. (2012). Reproductive health. Retrieved June 20, 2012 from http://www.cdc.gov/reproductivehealth/TobaccoUsePregnancy/index.htm

28. March of Dimes Foundation. (2011). Staying safe. Retrieved June 20, 2012 from http://www.marchofdimes.com/pregnancy/stayingsafe.html

29. March of Dimes Foundation. (2012). Calculations. Retrieved June 20, 2012 from http://www.marchofdimes.com/peristats/calculations.aspx?reg=&top=&id=23

30. National Public Health and Hospital Institute. (2005). Barriers to prenatal care: Findings from a survey of low-income and uninsured women who deliver at safety net hospitals. Retrieved June 20, 2012 from http://www.naph.org/Publications/barrierstoprenatalcare.aspx?FT=.pdf

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36. Guttmacher Institute. (2012). State data center – Arkansas. Retrieved June 22, 2012 from http://www.guttmacher.org/datacenter/profiles/AR.jsp

DATA SOURCES

U.S. Census Bureau (2010). 2010 Census Summary File 1. Retrieved May 29, 2012, from http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml

Centers for Disease Control and Prevention (2012). Web-based Injury Statistics Query and Reporting System (WISQARS). Leading Causes of Death for National, Regional, and States. Retrieved May 29, 2012 from http://www.cdc.gov/injury/wisqars/leading_causes_death.html

U.S. Census Bureau. (2010). 2010 Census Redistricting Data Summary File (GCT-PL1). Retrieved May 29, 2012 from http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml

U.S. Census Bureau. (2010). American Community Survey 1-Year Estimates (Multiple tables). Retrieved May 29, 2012 from http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml

U.S. Census Bureau. (2009). American Community Survey Selected Population Profile (S0201). Retrieved May 29, 2012 from http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml

Centers for Disease Control and Prevention. (2005-2010). Behavioral Risk Factor Surveillance System Survey Data (Arkansas). Atlanta, Georgia: U.S. Department of Health and Human Service.

Centers for Disease Control and Prevention. (2007-2009). United States Cancer Statistics: 1999 – 2008, WONDER Online Database. Retrieved May 29, 2012 from http://wonder.cdc.gov/

Centers for Disease Control and Prevention. (2008). CDC’s Pregnancy Risk Assessment Monitoring System Online Data for Epidemiologic Research (CPONDER). Retrieved June 4, 2012 from http://apps.nccd.cdc.gov/cPONDER/

March of Dimes: PeriStats. (2006-2008). Inadequate prenatal care (Arkansas). Retrieved June 4, 2012 from http://www.marchofdimes.com/peristats/ViewSubtopic.aspx?reg=05&top=5&stop=37&lev=1&slev=4&obj=1&dv=mswon

The Kaiser Family Foundation (2009-2010). Arkansas: Health coverage & uninsured. Retrieved June 4, 2012 from http://www.statehealthfacts.org/profileind.jsp?cat=3&rgn=5

Martin, J. A., Hamilton, B. E., Ventura, S. J., Osterman, M. J. K., Kirmeyer, S., Mathews, T. J., & Wilson, E. (2011). Births: Final data for 2009. National Vital Statistics Reports, 60(1). Retrieved June 13, 2012 from http://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdf

The Trustees of Dartmouth College. (2012). Medicare reimbursements per enrollee, by race and program component. The Dartmouth Atlas of Health Care. Retrieved July 5, 2012 from http://www.dartmouthatlas.org/data/table.aspx?ind=124&tf=10&ch=19,34&loc=5&loct=2&fmt=149

http://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdf

[health status of african americans in arkansas] · in addition, 34.3% of all african americans...

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