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Conceptual Framework:Conceptual Framework:
Health Disparities inHealth Disparities in
African-American WomenAfrican-American Women
Antronette (Toni) Yancey, MD, MPHAntronette (Toni) Yancey, MD, MPH
Associate Professor/Co-Director,Associate Professor/Co-Director,
UCLA School of Public Health andUCLA School of Public Health and
Center to Eliminate Health DisparitiesCenter to Eliminate Health Disparities
Race / Ethnic Composition of theRace / Ethnic Composition of the
Los Angeles County Population, 1990 and 2000Los Angeles County Population, 1990 and 2000
Black
Asian/PI
Other
Latino
White
Black
Asian/PI
OtherWhite
Latino
1990
n= 8,863,164
2000
n=9,519,338
37.8%
0.7%
40.8% 31.1% 12.0%
9.5%
44.6%
10.2%
10.5%
2.8%
Percentage of Adults (Age 18 years and older)Percentage of Adults (Age 18 years and older)
living below 200% of Federal Poverty Level,living below 200% of Federal Poverty Level,
by Service Planning Area, Los Angeles County, 1999by Service Planning Area, Los Angeles County, 1999
30%
50%
29%
73%
48%
33%
35%36%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Antelope
Valley
San
Fernando
San Gabriel Metro West South East South Bay
LA County
40%
1999-2000 Los Angeles County Health Survey
Department of Health Services, Public Health
Percentage of Children (Percentage of Children (≤≤17 years old)17 years old)
Living in Poverty by Race/Ethnicity,Living in Poverty by Race/Ethnicity,
Los Angeles County, 1999-2000Los Angeles County, 1999-2000
46%
9%
37%
21%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Latino White African American Asian/Pacific
Islander
1999-2000 Los Angeles County Health Survey
Department of Health Services, Public Health
Life Expectancy at Birth by Sex and Race/Ethnicity,Life Expectancy at Birth by Sex and Race/Ethnicity,
Los Angeles County, 1998Los Angeles County, 1998
74.3 74.3
76.4
66.4
77.878.0 77.7
79.8
72.5
80.7
60
65
70
75
80
85
Total White Latino Black Asian/PI
Years
Male
Female
Obj. 19-2
Total
White
Female
Male
Black
Female
Male
Mexican American
Female
Male
Target
Adult Obesity: 1988-94 to 1999-2000
0 10 20 30 40 50
Note: Data are for ages 20 years and over, age adjusted to the 2000 standard population.
Obesity is defined as BMI >= 30.0. Black and white exclude persons of Hispanic origin. Persons
of Mexican-American origin may be any race.
Source: National Health and Nutrition Examination Survey, NCHS, CDC.
Percent
1988-94
Race/Ethnicity
0
100
200
300
400
500
600
Heart Disease Cancer Heart Disease Cancer
N-H White Black Hispanic
Asian Am Ind
Source: National Center for Health Statistics
Death rates by cause for persons aged 45 to 65, 1995
Men
Women
Deathsper100,000persons
0
50
100
150
200
250
300
350
400
450
500
Men Women
N-H White Black Hispanic Asian or PI Am Ind
Age-adjusted, 1998 data
Source: National Center for Health Statistics, Health US 2000, table 31
Years of Potential Life Lost to Diabetes
YPLLbeforeage75yper
100,000population
Hypertension & OverweightHypertension & Overweight
Rates: Women in the U.S.Rates: Women in the U.S.
Hypertension,%Hypertension,% Overweight, %Overweight, %
WW BB LatLat WW BB LatLat
AllAll 19.319.3 34.234.2 22.022.0 32.532.5 53.353.3 51.851.8
PoorPoor 30.230.2 39.939.9 24.524.5 42.042.0 55.055.0 54.954.9
NearNear
poorpoor
23.923.9 35.935.9 22.422.4 36.636.6 51.051.0 48.748.7
Mid,Mid,
Hi inc.Hi inc.
20.220.2 30.030.0 25.225.2 30.030.0 52.452.4 45.345.3
Years of Potential Life LostYears of Potential Life Lost
by Ethnicity (per 100,000)by Ethnicity (per 100,000)
0
2000
4000
6000
8000
10000
12000
14000
Total
Afr Am
Am I nd
AsianPI
Latino
White
30
3
7
100
0
20
40
60
80
100
120
1900 2000
Year
Rateper1,000
Infant (<1)
Child (1-19)
Infant and Child Mortality Rates in theInfant and Child Mortality Rates in the
United States, 1900 and 2000United States, 1900 and 2000
Infant Mortality RateInfant Mortality Rate
Los Angeles County, 1990-2000Los Angeles County, 1990-2000
0
4
8
12
16
20
Rateper1,000livebirths
Rate 8 7.8 7.2 7.3 6.9 6.7 5.9 5.9 5.9 5.4 4.9
Number 1,628 1,588 1,421 1,381 1,252 1,176 999 950 936 841 777
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000
Infant Mortality Rate by Mother’s Race/Ethnicity,Infant Mortality Rate by Mother’s Race/Ethnicity,
Los Angeles County, 1991-2000Los Angeles County, 1991-2000
0
2
4
6
8
10
12
14
16
18
20
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000
Year
Rateper1,000livebirths
White
Latino
African
American
Asian/ Pacific
Islander
Birth Rate Among Teens Aged 15-17 Years byBirth Rate Among Teens Aged 15-17 Years by
Mother’s Race/Ethnicity,Mother’s Race/Ethnicity,
Los Angeles County, 1991-2000Los Angeles County, 1991-2000
0
10
20
30
40
50
60
70
80
90
100
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000
Year
Rateper1,000
White
Latina
African
American
Asian /Pacific
Islander

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Conceptual Framework: Health Disparities in African-American Women

  • 1. Conceptual Framework:Conceptual Framework: Health Disparities inHealth Disparities in African-American WomenAfrican-American Women Antronette (Toni) Yancey, MD, MPHAntronette (Toni) Yancey, MD, MPH Associate Professor/Co-Director,Associate Professor/Co-Director, UCLA School of Public Health andUCLA School of Public Health and Center to Eliminate Health DisparitiesCenter to Eliminate Health Disparities
  • 2. Race / Ethnic Composition of theRace / Ethnic Composition of the Los Angeles County Population, 1990 and 2000Los Angeles County Population, 1990 and 2000 Black Asian/PI Other Latino White Black Asian/PI OtherWhite Latino 1990 n= 8,863,164 2000 n=9,519,338 37.8% 0.7% 40.8% 31.1% 12.0% 9.5% 44.6% 10.2% 10.5% 2.8%
  • 3. Percentage of Adults (Age 18 years and older)Percentage of Adults (Age 18 years and older) living below 200% of Federal Poverty Level,living below 200% of Federal Poverty Level, by Service Planning Area, Los Angeles County, 1999by Service Planning Area, Los Angeles County, 1999 30% 50% 29% 73% 48% 33% 35%36% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Antelope Valley San Fernando San Gabriel Metro West South East South Bay LA County 40% 1999-2000 Los Angeles County Health Survey Department of Health Services, Public Health
  • 4. Percentage of Children (Percentage of Children (≤≤17 years old)17 years old) Living in Poverty by Race/Ethnicity,Living in Poverty by Race/Ethnicity, Los Angeles County, 1999-2000Los Angeles County, 1999-2000 46% 9% 37% 21% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Latino White African American Asian/Pacific Islander 1999-2000 Los Angeles County Health Survey Department of Health Services, Public Health
  • 5. Life Expectancy at Birth by Sex and Race/Ethnicity,Life Expectancy at Birth by Sex and Race/Ethnicity, Los Angeles County, 1998Los Angeles County, 1998 74.3 74.3 76.4 66.4 77.878.0 77.7 79.8 72.5 80.7 60 65 70 75 80 85 Total White Latino Black Asian/PI Years Male Female
  • 6. Obj. 19-2 Total White Female Male Black Female Male Mexican American Female Male Target Adult Obesity: 1988-94 to 1999-2000 0 10 20 30 40 50 Note: Data are for ages 20 years and over, age adjusted to the 2000 standard population. Obesity is defined as BMI >= 30.0. Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race. Source: National Health and Nutrition Examination Survey, NCHS, CDC. Percent 1988-94 Race/Ethnicity
  • 7. 0 100 200 300 400 500 600 Heart Disease Cancer Heart Disease Cancer N-H White Black Hispanic Asian Am Ind Source: National Center for Health Statistics Death rates by cause for persons aged 45 to 65, 1995 Men Women Deathsper100,000persons
  • 8. 0 50 100 150 200 250 300 350 400 450 500 Men Women N-H White Black Hispanic Asian or PI Am Ind Age-adjusted, 1998 data Source: National Center for Health Statistics, Health US 2000, table 31 Years of Potential Life Lost to Diabetes YPLLbeforeage75yper 100,000population
  • 9. Hypertension & OverweightHypertension & Overweight Rates: Women in the U.S.Rates: Women in the U.S. Hypertension,%Hypertension,% Overweight, %Overweight, % WW BB LatLat WW BB LatLat AllAll 19.319.3 34.234.2 22.022.0 32.532.5 53.353.3 51.851.8 PoorPoor 30.230.2 39.939.9 24.524.5 42.042.0 55.055.0 54.954.9 NearNear poorpoor 23.923.9 35.935.9 22.422.4 36.636.6 51.051.0 48.748.7 Mid,Mid, Hi inc.Hi inc. 20.220.2 30.030.0 25.225.2 30.030.0 52.452.4 45.345.3
  • 10. Years of Potential Life LostYears of Potential Life Lost by Ethnicity (per 100,000)by Ethnicity (per 100,000) 0 2000 4000 6000 8000 10000 12000 14000 Total Afr Am Am I nd AsianPI Latino White
  • 11. 30 3 7 100 0 20 40 60 80 100 120 1900 2000 Year Rateper1,000 Infant (<1) Child (1-19) Infant and Child Mortality Rates in theInfant and Child Mortality Rates in the United States, 1900 and 2000United States, 1900 and 2000
  • 12. Infant Mortality RateInfant Mortality Rate Los Angeles County, 1990-2000Los Angeles County, 1990-2000 0 4 8 12 16 20 Rateper1,000livebirths Rate 8 7.8 7.2 7.3 6.9 6.7 5.9 5.9 5.9 5.4 4.9 Number 1,628 1,588 1,421 1,381 1,252 1,176 999 950 936 841 777 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000
  • 13. Infant Mortality Rate by Mother’s Race/Ethnicity,Infant Mortality Rate by Mother’s Race/Ethnicity, Los Angeles County, 1991-2000Los Angeles County, 1991-2000 0 2 4 6 8 10 12 14 16 18 20 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 Year Rateper1,000livebirths White Latino African American Asian/ Pacific Islander
  • 14. Birth Rate Among Teens Aged 15-17 Years byBirth Rate Among Teens Aged 15-17 Years by Mother’s Race/Ethnicity,Mother’s Race/Ethnicity, Los Angeles County, 1991-2000Los Angeles County, 1991-2000 0 10 20 30 40 50 60 70 80 90 100 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 Year Rateper1,000 White Latina African American Asian /Pacific Islander

Notes de l'éditeur

  1. Observed risk disparities translate into disease burden disparities.
  2. Source: National Center for Health Statistics, 1988-1994