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Racial and Ethnic Minorities
In 2000, about 30% of the U.S. population identified themselves as members of racial or ethnic minority groups. By 2050, it is projected that these groups will account for almost half of the U.S. population2. Census 2000 counted over 36 million blacks or African Americans (12.9% of the U.S. population)3; over 35 million Hispanics or Latinos who live in the U.S. (12.5%) and another 3.8 million who live in the Commonwealth of Puerto Rico 4; almost 12 million Asians (4.2%)5; 874,000 Native Hawaiians and Other Pacific Islanders (0.3%)6; and over 2 million American Indians and Alaska Natives (0.7%), of whom 38% reside on Federal trust lands7. Racial and ethnic minorities are more likely than non-Hispanic whites to be poor or near poor8. In addition, Hispanics, blacks, and some Asian subgroups are less likely than non-Hispanic whites to have a high school education9. In general, racial and ethnic minorities often experience worse access to care and lower quality of preventive, primary, and specialty care8,9.
In previous chapters of this report, health care differences by raciali and ethnicii categories as defined by the Office of Management and Budget (OMB) and used by the U.S. Census Bureau are described10. In this section, quality of and access to health care for each minority group are summarized. While a large number of quality of and access to care measures are examined in the NHDR, a subset of measures, for which comparable data are available for 2000 and 2001, are highlighted in this section. Specifically, this subset consists of 38 measures of effectiveness of health care and 31 measures of access to health care. Data sources are the Surveillance, Epidemiology, and End Results program, U.S. Renal Data System, Medical Expenditure Panel Survey, the CDC AIDS Surveillance System, National Vital Statistics System-Natality, National Immunization Survey, National Health Interview Survey, and National Hospital Discharge Survey. Mortality and health care utilization measures are not included to allow focus on quality and access measures more directly related to health care. Data on all measures were not available for all groups. Go to Tables 1.2 and 1.3 for lists of measures available for each group and Appendix C for data on each measure for each group. Changes in differences related to race and ethnicity between 2000 and 2001 are examined. For each group, a measure can be worse than, about the same as, or better than an appropriate comparison group. Only relative differences of at least 10% and that are statistically significant with p < 0.05 are discussed in this report.
The 2003 NHDR examined differences in health care by patient language as well as differences in health care among various Hispanic and Asian subgroups and among American Indians and Alaska Natives who obtain care from Indian Health Service (IHS) facilities. New data on language and subgroups are not available this year, so the 2004 NHDR does not contain a corresponding section; it is anticipated that new data will be available for the next NHDR. The current report does include expanded measures related to care delivered by IHS facilities.
i Races include: black or African American, Asian, Native Hawaiian or Other Pacific Islander, American Indian and Alaska Native, and white.
ii Ethnicity differentiates Hispanics and non-Hispanics. This report also distinguishes non-Hispanic whites and non-Hispanic blacks.