America Becoming Racial Trends and Their Consequences: Volume II (2001) / Chapter Skim
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13. The heal th of Minority Children in the Year 2000: The Role of Government Programs in Improving the Health Status of America's Children
13. The heal th of Minority Children in the Year 2000: The Role of Government Programs in Improving the Health Status of America's Children
Pages 351-370
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From page 351... ...
This paper addresses selected health-status indicators and goals from the federal government's Healthy People 2000 initiative (National Center for Health Statistics, 1996) , noting trends, factors that influence the indicators, programs or policies designed to improve health outcomes, and considerations for future research as it relates to minority children.
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From page 352... ...
As the percentage of minority children in this country grows, the persistence of disparities in attaining optimal health and development will threaten the foundation on which we are building future contributing citizens, workers, and leaders. The question is whether we, as a society, have the will and commitment to invest our resources in reversing negative trends and accelerating positive ones.
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From page 353... ...
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From page 354... ...
Infant mortality and child immunizations, the indicators chosen for discussion here, are among those highlighted in the President's Initiative to end racial disparity in health status for children. Two more indicators, teen births and violent injuries in youth, were selected based on marked discrepancies in the prevalence of these health risk behaviors or conditions between minority youth, particularly Black, and nonminority youth.
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From page 356... ...
Infant mortality rates are quite diverse, however, when one also examines rates for other ethnic minorities, especially when one factors in the components of infant mortality i.e., neonatal mortality (death within the first 27 days
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From page 357... ...
. Hispanics have infant mortality rates very similar to Whites; American Indians and Alaska Natives have rates midway between Whites and Blacks; Asians and Pacific Islanders have the lowest rates.
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From page 358... ...
358 23.8 42.2 56.7 20.8 41.4 50.9 1 1991 1992 1993 THE HEALTH OF MINORITY CHILDREN IN THE YEAR 2000 80 70.5 61 .8 l 68.4 58.7 55.9 1 _ _ ~ 40 60 20 —O Below poverty level At or above poverty level Black White FIGURE 13-3 Percent of children 19-35 months who received the combined series immunizations (4:3:1:3~) , by race, Hispanic origin, and poverty status.
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From page 359... ...
If the annual incremental gains continue at their current pace, Asian and Pacific Islander children may reach the target; however, other ethnic groups, including Whites and poor children, would have to accelerate their gains significantly to reach the goal. Teen Births Teen births have been linked to increased vulnerability to adverse social, economic, and psychosocial risks for both the mothers and their children.
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From page 360... ...
Hispanic American Indian/Alaska native FIGURE 13-4 Percent of children 19-35 months who received the combined series immunizations (4:3:1~) , by race and poverty status.
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From page 361... ...
Hispanic \ American Indian White Asian or Pacific Islander / \\ '/`'—`N \ / \ / ~ - / 1 1 1 1 1960 1970 1980 1990 1996 FIGURE 13-5 Birth rate for teenagers 15-19 years by race and Hispanic origin: United States. SOURCE: National Center for Health Statistics.
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From page 362... ...
The overall infant mortality goal will probably be met, as will the targets for Puerto Rican and American Indian and Alaska Native infants. The target is unlikely to be met for Black infants, however.
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From page 364... ...
The Healthy Start Initiative is the most recent federal program directed toward reducing infant mortality at the community level. During the initial phase of the program, which began in 1991, the Health Resources Service Administration funded five-year demonstration projects in 15 communities with the ambitious goal of reducing infant mortality rates by 50 percent within the five-year project period.
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From page 365... ...
Poverty, minority status, and lack of health insurance exerted independent effects on access to and use of primary care. Poor children, minority children, and uninsured children were twice as likely as children in the mainstream to lack a usual source of care, to wait longer at the site of care, and to receive fewer physician services after controlling for health status (Newacheck et al., 1996~.
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From page 366... ...
The program strategies have varied widely from concentrating on delaying sexual activity in young teens through comprehensive approaches to addressing academic skills, social skills, and contraceptive knowledge, to offering family planning and counseling services in school settings or adjacent to schools. Violent Injury The CDC has led the major research effort in community interventions for violence prevention programs.
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From page 367... ...
When the data set allows, specific ethnic subgroup analysis is preferable in Hispanic and Asian and Pacific Islander populations, given the differing baseline and outcome data that may emerge in such subpopulations. Poverty has been so inextricably linked to minority groups, because of the disproportionate representation of minority families with annual incomes below the poverty level, that intragroup studies with more middle-income representation should be considered when "teasing" out effects of financial as well as nonfinancial barriers to access and changes in health behavior.
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From page 368... ...
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From page 369... ...
The four addressed in this paper infant mortality, childhood immunization, teen pregnancy, and youth violence are among the most glaring at the national level, but others may be more evident in differing communities. The work that continues to be done for the next iteration of Healthy People, the goals for 2010, is to set forth a process that promotes wide dissemination in a manner that allows researchers and policy makers to help shape these new targets.
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From page 370... ...
1998 Report to Congressional Requesters, Healthy Start Preliminary Results from National Evaluation Are Not Conclusive: Preliminary Evaluation of Healthy Start.
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