Health and Inequality in the United States
Learning Outcomes
- Explain disparities of health based on gender, socioeconomic status, race, and ethnicity in the United States
Health by Race and Ethnicity
When looking at the social epidemiology of the United States, it is hard to miss the disparities among races. Racial minorities exhibit lower life expectancy and a higher likelihood of death by heart disease and stroke. In terms of infant mortality, indigenous populations have an infant mortality rate that is 60% higher than the rate for whites, while infants born to African American women exhibited the highest rate of infant mortality.[1] According to a report from the Henry J. Kaiser Foundation (2007), African Americans also have a higher incidence of several other diseases and causes of mortality, from cancer to heart disease to diabetes. In a similar vein, it is important to note that ethnic minorities, including Mexican Americans and Native Americans, also have higher rates of these diseases and causes of mortality than whites.
Lisa Berkman (2009) notes that this gap started to narrow during the Civil Rights movement in the 1960s, but it began widening again in the early 1980s. What accounts for these perpetual disparities in health outcomes among different ethnic groups? Much of the answer lies in the level of healthcare that these groups receive. The National Healthcare Disparities Report (2010) shows that even after adjusting for insurance differences, racial and ethnic minority groups receive poorer quality of care and less access to care than dominant groups. The Report identified these racial inequalities in care:
- Black Americans, American Indians, and Alaskan Natives received inferior care when compared with white Americans for about 40 percent of measures.
- Asian ethnic groups received inferior care for about 20 percent of measures.
- Among whites, Hispanic whites received 60 percent inferior care of measures compared to non-Hispanic whites (Agency for Health Research and Quality 2010). When considering access to care, the figures were comparable.
The Hispanic Paradox: The Curious Case of Hispanics in the United States
Recent academic research by Lariscy, Hummer, and Hayward (2015)[2] has sought to explore what is traditionally known as the Hispanic paradox of health. The paradox suggests that Hispanic older adult mortality is similar to that of whites and that it actually exceeds white life expectancy, despite their initial lower life expectancy at birth and their socioeconomic disadvantage, which is comparable to the one found among African Americans. These scholars found that Hispanics, regardless of where they were born, exhibit higher life expectancy as adults than any other group. Foreign-born Hispanics living in the U.S. have an even higher life expectancy and exhibit lower mortality ratios for lung cancer and respiratory diseases, which is likely a result of lower rates of smoking. All of this despite their lower socioeconom