the emerging minority majority problems and prospects for health disparities research
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The Emerging Minority-Majority: Problems and Prospects for Health Disparities Research. Thomas A. LaVeist, PhD Professor of Health Policy and Management and Sociology Director, Center for Health Disparities Solutions Johns Hopkins Bloomberg School of Public Health. A New American Revolution.

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the emerging minority majority problems and prospects for health disparities research

The Emerging Minority-Majority:Problems and Prospects for Health Disparities Research

Thomas A. LaVeist, PhD

Professor of Health Policy and Management and Sociology

Director, Center for Health Disparities Solutions

Johns Hopkins Bloomberg School of Public Health

percentage resident population by race ethnicity u s 1950 2000
Percentage Resident Population by race/ethnicity, U.S. 1950-2000

Source: National Center for Health Statistics (2002)

projected percentage resident population by race ethnicity u s 2010 2070
Projected Percentage Resident Population by race/ethnicity, U.S. 2010-2070

Source: U.S. Bureau of the Census:(NP-T5) Projections of the Resident

Population by Race, Hispanic Origin, and Nativity: Middle Series, 1999 to 2100

the demographic transition
The Demographic Transition
  • Stage 1 - Pre-modern Stage
  • Stage 2 – Early industrialization and urbanization
  • Stage 3 – Mature industrial stage
  • Stage 4 – Post-industrial stage
slide8

http://www.digitalopportunity.org/imagecatalogue/imageview/12898/?RefererURL=/contact/company/view/5130http://www.digitalopportunity.org/imagecatalogue/imageview/12898/?RefererURL=/contact/company/view/5130

Accessed February 27, 2006

population implosion
Population Implosion

Low Fertility and Population Ageing: Causes, Consequences, and Policy Options, by Jonathan Grant, Stijn Hoorens, Suja Sivadasan, Mirjam van het Loo, Julie DaVanzo, Lauren Hale, Shawna Gibson, and William Butz, MG-206-EC, 2004, 172 pp. Rand Research Brief

us fertility rate 1950 2000
US Fertility Rate, 1950-2000

Source: National Center for Health Statistics (2002)

the 5 th stage multi culturalism
The 5th Stage – Multi-Culturalism
  • Stage 4 countries attract immigration from pre-Stage 4 countries
  • The immigrant population will have a larger percentage in the childbearing ages range
  • The immigrant population will have a higher birth rate
stage 4 and pre stage 4 status of country of birth for foreign born u s population 1990 1997
Stage 4 and Pre-stage 4 status of country of birth for foreign-born U.S. population, 1990-1997
the minority majority
The Minority-Majority
  • Accelerate globalization
  • Competitive advantage in the global economy
  • Well adapted business will have advantage in domestic marketplace
projected percentage resident population by race ethnicity u s 2010 20701
Projected Percentage Resident Population by race/ethnicity, U.S. 2010-2070

Source: U.S. Bureau of the Census:(NP-T5) Projections of the Resident

Population by Race, Hispanic Origin, and Nativity: Middle Series, 1999 to 2100

slide18

Framingham, MA

Evans County, GA

Washington County, Maryland

Alameda County

Tecumsh, MI

example
Example
  • 2002 National Health Interview Survey (NHIS), n=93,386
  • N=33,148 adults age 40+ with complete data on income, race and ADL
  • African Americans, n=4473 (12%)
  • Income, <$20K=6813; $20K-$75K=19,504; >$75K=6831
  • At least 1 ADL = 1043 (2.8%)
slide33

Health Disparities Research is further confounded because of racial segregation

White

Black

Racial Status Determines the way

in which you “experience” America

median income
Median Income

Source: US Censes 2000

educational status
Educational Status

Source: US Censes 2000

slide40
Sex

Source: US Censes 2000

the study
The Study
  • Adult Residents of the 2 census tracts
  • 40 Minute Interview
  • Interviews In-person at home or at health fair
  • 3 Blood pressure measurements
  • Cuffs calibrated at Johns Hopkins Hospital
  • 35 Interviewers
  • Interviewer Incentives
  • Respondent Incentives
  • Successfully Interviewed N=1498 (42.14%)
median income by race
Median Income By Race

T = -1.942 df=1284 95%CI(-.464,.002)

educational status by race
Educational Status by Race

X2 = 45.96 df=4 p<.0001

slide46
Sex

X2 = .22 df 1 p=.312

local vs national race disparity comparisons
Local vs. National Race Disparity Comparisons*

* Compared with the National Health Interview Survey, 2001

undiagnosed and uncontrolled hypertension systolic
Undiagnosed and Uncontrolled Hypertension (Systolic)

Rates are NOT adjusted for age or education.

matched sample
Matched Sample

Adjusted for age, gender, smoking, BMI, education, income & Insurance

matched sample analysis
Matched Sample Analysis

Adjusted for income, BMI, education, health insurance, sex, and age

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