Page 51 - Cultural Competence in Health Education

Disparities in Health Among Racial and Ethnic Groups 29

and act on, and in words that people actually use when talking about sexual and injec-
tion practices. Patients need to be counseled on prevention strategies, including harm
reduction, in nonjudgmental ways. Patients need to be taught the benefits of knowing

whether they are HIV positive or negative (their serostatus) and their right to receive
effective drug therapies. It is also crucial that communities partner with health care pro-
fessionals to reduce the impact of the HIV/AIDS epidemic on minority communities.

Adult and Child Immunization Rates
Although recent efforts have narrowed the gap in immunization rates between minority
and non - Hispanic white populations, this nation is still below the goal set in Healthy
People 2010 to achieve and maintain childhood immunizations at 90 percent and to

increase influenza and pneumococcal immunizations to 60 percent among all older
adults (65 years of age and older) (Niederhauser & Stark, 2005; Zimmerman, 2007).
Also, although disparities in childhood vaccination coverage have decreased, largely
due to the Childhood Immunization Initiative (CDC, 2007a), some disparities still exist.
The U.S. Department of Health and Human Services has developed a plan, the
National Immunization Program (NIP), to improve adult and child immunization rates.
This plan includes public and provider awareness campaigns, enhanced delivery of
immunization services, and more assessment of the barriers to immunization. NIP has

developed special programs for specific groups of people, including adults, infants and
toddlers, pre - teens and adolescents, college students and young adults, parents, preg-
nant women, seniors, and racial and ethnic minorities. The program is community
based and works with universities, clergy, health care professionals, churches, and
senior centers to encourage vaccination (CDC, 2007g). Physicians and health educa-
tors must take leadership roles to help children and adults be vaccinated.
Vaccines for Children (VFC) is a program that funds free vaccines for low - income
children and is administered through NIP. States and eligible U.S. projects enroll doc-
tors, who then identify low - income children eligible for services (CDC, 2007h). Adult
vaccination rates are lower than they need to be because of lack of information: adults
may not know which immunizations are needed, and health care providers, including
health educators, may not recommend vaccines to their adult clients. Many adults are
also afraid of adverse reactions to vaccines and do not understand the threat of infl u-
enza and pneumococcal disease to older adults. Health educators have a vital role to
work with their adult clients to educate them concerning the need to be vaccinated
against influenza and pneumococcal disease.

Infant Mortality
The infant mortality rate (IMR) is an international measure used within and between
nations to compare the health and well - being of populations. The IMR is often used as
an overall measure of a country ’ s health care status because it is sensitive to many of
the underlying determinants of health status, including literacy, economic factors such
as overall income, and the relative position of women in a society — their educational
level, literacy, socioeconomic status, right to make their own reproductive health

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