Thursday, January 20, 2011

CDC Releases New Health Disparities Report: What’s Missing?

The Centers for Disease Control and Prevention has issued a landmark report on health disparities – the first produced by the CDC that covers a variety of health problems. Areas addressed include environmental health, health care access, infant deaths, motor vehicle deaths, suicides, HIV infection, obesity and diabetes, among other areas. It’s required reading for those of us working to end health disparities and is a nice companion piece to the recently released Healthy People 2020 document.

Having said that, there will probably be discussion about the health areas that were not included in this health disparities report. Here’s how the CDC folks explained what was and what wasn’t included in the report:

Topics included in CHDIR 2011 were selected on the basis of one or more of the following criteria: 1) leading causes of premature death among segments of the U.S. population as defined by sex, racial/ethnicity, income or education, geography, and disability status; 2) social, demographic, and other disparities in health outcomes; 3) health outcomes for which effective and feasible interventions exist; and 4) availability of high-quality national-level data.

It can be argued that areas such as breast cancer qualify to be addressed on the basis of the aforementioned criteria. Breast cancer is clearly a major cause of premature death; demographic disparities exist (African American women have disproportionately high mortality rates), effective interventions (early screening and detection) exist, and high-quality national-level data (vital statistics) are available. Why wasn’t breast cancer addressed in this report?

For those of us focused on issues that face Asian Americans and Pacific Islanders, there is the question as to why hepatitis B was not addressed in this report. Hepatitis B among AAPIs also meets at least three (and arguably four) of the four aforementioned criteria. In a prior blog entry, I had commented on the lack of attention to hepatitis B in the Healthy People 2020 document. There would seem to be a pattern here.

Clearly, more work remains for those of us advocating for more attention to the silent epidemic of hepatitis B – particularly among AAPIs. In a future entry, I will discuss a short term opportunity to provide important input to the federal government on this topic.

-Doug Hirano, MPH, APCA Executive Director

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