Evaluating the State of Black Health in Indiana
Indiana Epidemiology Newsletter
February 2007
Antoniette M. Holt, MPH
Minority Health Epidemiologist
February is Black History Month. This long celebrated event reflects on the contributions made by Blacks to society as we know it today. From the brush you use every day (Lydia O. Newman), to the stoplight that you fuss at daily (Garret A. Morgan), there are many things that can be credited to the imagination, ingenuity, and process of a great people. Unfortunately, even with today’s technology and health advancements, health disparities still exist, and Blacks suffer illnesses and death rates at one to two times more than their White counterparts.
This article addresses health disparities and how those disparities impact Blacks in Indiana. The 2005 U.S. Census Bureau’s data show that 8.6 percent of Indiana’s total population (or 522,377 people) are Black. Blacks are the largest racial minority in Indiana to date.
The U.S. Department of Health and Human Services defines health disparities as gaps in the quality of health and health care across racial and ethnic groups. The effects of these disparities are reflected in disease incidence, health outcomes, and health care access. Reasons contributing to health disparities include lack of health coverage, socioeconmic factors, linguistic barriers, cultural beliefs and differences, lack of providers, lack of education, discrimination, etc.
In Indiana, health disparities are everpresent within data collected. The leading causes of death for Blacks in Indiana in 2004 (the most recent data available) were:
|
Cause |
Rank |
African American/Black |
|---|---|---|
|
Total |
|
4,279 |
|
Diseases of heart |
1 |
1,067 |
|
Malignant neoplasms |
2 |
945 |
|
Cerebrovascular diseases |
3 |
251 |
|
Diabetes mellitus |
4 |
191 |
|
Assault (homicide) |
5 |
175 |
|
Accidents |
6 |
172 |
|
Nephritis, nephrotic syndrome and nephrosis |
7 |
139 |
|
Chronic lower respiratory diseases |
8 |
117 |
|
Septicemia |
9 |
102 |
|
Certain conditions originating in the perinatal period |
10 |
88 |
|
Alzheimer’s disease |
11 |
75 |
|
Essential (primary) hypertension & hypertensive renal disease |
12 |
71 |
|
Influenza and pneumonia |
13 |
51 |
|
Human immunodeficiency virus (HIV) disease |
14 |
48 |
|
Chronic liver disease and cirrhosis |
15 |
44 |
2004 Indiana Mortality Report, leading causes of death
Although these numbers may seem small, the age-adjusted death rates depict a larger disparity gap. For diabetes in Indiana, the 2004 total age-adjusted death rate was 26.3 per 100,000 population. The age-adjusted death rate for Blacks was 49.7 per 100,000 population.
Other diseases that have higher age-adjusted death rates for Blacks than for other races or ethnicities in Indiana include: heart disease, cancer, stroke, homicide, HIV/AIDS, and certain conditions during the perinatal period. In 2004, the infant mortality rate for Blacks was 17.1 per 1,000 live births compared to the rate for Whites, which was 6.9 per 1,000 live births. The state average was 8.1 per 1,000 live births. This example illustrates how some numbers for Blacks were more than double the state average.
Health disparities are also causing years of potential life to be lost. Years of Potential Life Lost (YPLL) is a measurement of premature mortality. When looking at specific state mortality rates, YPLL can be most helpful for planning and evaluating local public health interventions. For example, when looking at heart disease in Indiana, for 2004, Blacks had 10,984 years of potential life lost.
The numbers continue to show the same outcomes across different diseases. Through interventions such as the annual Black and Minority Health Fair at Indiana Black Expo or the INShape Indiana initiative from the Indiana State Department of Health and its partners, as well as other national, state, and local entities, programs and venues are being created or continue to grow to help stop this emergent rate of health disparities.
Much more must be done to reach the Healthy People 2010 goal of eliminating health disparities among racial and ethnic minorities.
To quote Dr. Martin Luther King, Jr., “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”
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