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

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  1. 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

  2. A New American Revolution

  3. Percentage Resident Population by race/ethnicity, U.S. 1950-2000 Source: National Center for Health Statistics (2002)

  4. 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

  5. The Demographic Transition • Stage 1 - Pre-modern Stage • Stage 2 – Early industrialization and urbanization • Stage 3 – Mature industrial stage • Stage 4 – Post-industrial stage

  6. Source: Time Magazine January 11, 1960

  7. 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

  8. 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

  9. US Fertility Rate, 1950-2000 Source: National Center for Health Statistics (2002)

  10. The 5th demographic stage

  11. 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

  12. Stage 4 and Pre-stage 4 status of country of birth for foreign-born U.S. population, 1990-1997

  13. The Minority-Majority • Accelerate globalization • Competitive advantage in the global economy • Well adapted business will have advantage in domestic marketplace

  14. 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

  15. Framingham, MA Evans County, GA Washington County, Maryland Alameda County Tecumsh, MI

  16. Disentangling Race and Class Race Class

  17. 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%)

  18. ADL regressed on race

  19. ADL regressed on Income

  20. ADL regressed on race

  21. Cross tabulation of race and ADL within income groupings

  22. A Baltimore Area High School

  23. A Baltimore Area High School

  24. A Baltimore Area High School

  25. A Baltimore Area High School

  26. A Baltimore Area High School

  27. A Baltimore Area High School

  28. A Baltimore Area High School

  29. A Baltimore Area High School

  30. Health Disparities Research is further confounded because of racial segregation White Black Racial Status Determines the way in which you “experience” America

  31. Community Census Profile of the Community

  32. Racial Distribution

  33. Median Income Source: US Censes 2000

  34. Percent Living Below Official Poverty Level Source: US Censes 2000

  35. Educational Status Source: US Censes 2000

  36. Sex Source: US Censes 2000

  37. 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%)

  38. Representativeness of the Sample and Race Differences in the Sample

  39. Racial Distribution of SWB Sample Percent N=841 N=572

  40. Median Income By Race T = -1.942 df=1284 95%CI(-.464,.002)

  41. Educational Status by Race X2 = 45.96 df=4 p<.0001

  42. Sex X2 = .22 df 1 p=.312

  43. Local vs. National Race Disparity Comparisons* * Compared with the National Health Interview Survey, 2001

  44. High Blood Pressure

  45. Heart Disease

  46. Cancer