Page 49 - Cultural Competence in Health Education

Disparities in Health Among Racial and Ethnic Groups 27

To summarize the vast research on health care disparities and cancer, that research
strongly suggests that African Americans and Hispanics are much more likely than
non - Hispanic whites to receive a lower quality of health care for cancer, including
lack of access to clinical trials, even when data are corrected for factors affecting
access, such as insurance status (CDC, 2007b).

Diabetes
Diabetes was the sixth leading cause of death in the year 2000. More than 17 million
people in the United States have diabetes, and each year over 200,000 people die from
the complications associated with diabetes (CDC, 2007c). Minorities are much more
likely to be diagnosed with diabetes than are non - Hispanic whites of a similar age.
African Americans and American Indians also have higher rates of diabetes - related
complications, including kidney disease and amputations. The Healthy People 2010
midcourse review, examining data available as of January 1, 2005, suggested that
some progress has been made toward meeting the two overarching goals to increase
quality and years of healthy life and reduce health disparities. However, when the data
were disaggregated, the disparities among racial and ethnic populations were largely
unchanged from the baseline assessments (CDC, 2006b). The most promising strate-
gies to reverse these alarming statistics focus on early screening and treatment. Once
diagnosed, individuals with diabetes need specialized self - management programs and
improved tracking to ameliorate their risks for major complications. The federally

qualified health centers (FQHCs) that serve low - income, largely minority, and often
undocumented populations have taken part in a health care collaboratives study con-
ducted with 9,558 patients in forty - four health centers nationwide. This study used
nationally validated quality measures before and after each intervention, focusing on
measures related to diabetes, asthma, and hypertension. The researchers found a
21 percent improvement in foot examinations for persons with diabetes and a 16 per-
cent increase in the level of screening for glycated hemoglobin, a measure of diabetes.
These efforts in improving chronic disease management involved focusing on tracking
health screening efforts, communicating the results to the patients, and making sure
that patients followed up on testing and examination results, along with making self -
management efforts such as improving diet and nutrition, increasing physical activity,
and tracking their efforts through patient logs (Agency for Healthcare Research and
Quality [AHRQ], 2007).

Coronary Heart Disease
Overall, minority and low - income populations have a disproportionate share of mor-
bidity and mortality from heart disease. Two goals of the Healthy People 2010 initiative
address this disproportionate burden of cardiovascular disease in the African American
community: one is to reduce deaths from heart disease among African Americans by
30 percent and the other is to reduce deaths from strokes among African Americans
by 47 percent (CDC, 2006c).

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