Progress Toward Elimination of Health Disparities

The following discussion highlights progress toward the elimination of health disparities. The disparities are illustrated in the Disparities Table (see Figure 26-2), which displays information about disparities among select populations for which data were available for assessment.

Some progress in reducing disparities was made. The Asian or Pacific Islander population had the best rates for the objectives and subobjectives regarding alcohol-related motor vehicle deaths (26-1a), cirrhosis deaths (26-2), and drug-induced deaths (26-3). The Asian population had the best rates for average age at first use of marijuana (26-9b), adult binge drinking (26-11c), adult males and females exceeding low-risk drinking guidelines (26-13a and b), and adolescents' perception of risk of smoking marijuana once a month (26-17b).

The black population had the best rates for high school seniors who have never used alcohol (26-9c), high school seniors who have never used illicit drugs (26-9d), high school senior binge drinking in the past 2 weeks (26-11a), 8th graders' steroid use in the past year (26-14a), 10th graders' steroid use in the past year (26-14b), 12th graders' steroid use in the past year (26-14c), 10th graders' disapproval of one to two drinks a day (26-16b), 12th graders' disapproval of one to two drinks a day (26-16c), and 12th graders' disapproval of trying marijuana (26-16f). The black non-Hispanic population had the best rates for adolescents who have not used alcohol or illicit drugs in the past 30 days (26-10a), adolescents who have used marijuana in the past 30 days (26-10b), adolescents' perception of risk of more than five drinks one to two times a week (26-17a), adolescents' perception of risk of using cocaine once a month (26-17c), treatment for illicit drug problems in the past year (26-18a), treatment for alcohol and illicit drug problems in the past year (26-18b), and treatment for alcohol abuse (26-21).

Females had better rates than males except for the following objectives for which males had the better rate: 9th through 12th graders' riding in the past 30 days with a driver who has been drinking (26-6), high school seniors who have never used alcohol (26-9c), adolescents who have had no alcohol or illicit drugs in the past 30 days (26-10a), adolescents' inhalant use in the past year (26-15), adolescents' perception of risk of using cocaine once a month (26-17c), treatment for illicit drug problems in the past year (26-18a), treatment for alcohol and illicit drug problems in the past year (26-18b), and treatment for alcohol abuse (26-21). The male rates were at least twice the female rates for alcohol-related motor vehicle deaths (26-1a), cirrhosis deaths (26-2), adult binge drinking (26-11c), and steroid use by 10th graders (26-14b).

Disparity measures for education level were available for cirrhosis deaths (26-2), drug-induced deaths (26-3), females aged 21 years and older who exceeded low-risk drinking guidelines in the past year 26-13a), and males aged 21 years and older who exceeded low-risk drinking guidelines in the past year (26-13b). Persons with at least some college had the best rates for all of these objectives and subobjectives except females aged 21 years and older who exceeded low-risk drinking guidelines in the past year (26-13a). The best group for this subobjective was high school graduates.

In general, the disparities with respect to income level were less than 10 percent or not statistically significant. Poor persons (mostly those with family incomes less than $20,000 per year) had the best rate for no alcohol or illicit drug use in the past 30 days by adolescents (26-10a); binge drinking in the past 30 days by adults (26-11c); binge drinking in the past 30 days by adolescents aged 12 to 17 years (26-11d); and adolescents aged 12 to 17 years who perceived risk in having five or more drinks one to two times per week (26-17a), smoking marijuana once a month (26-17b), using cocaine once a month (26-17c), as well as for treatment for alcohol and illicit drug problems in the past year (26-18b), and treatment for alcohol abuse (26-21).

Progress in reducing disparities among population groups was mixed. Disparities in binge drinking decreased over time by 10 to 49 percentage points between groups for three subobjectives: white and black high school seniors (26-11a), male and female high school seniors (26-11a), and male and female college students (26-11b). Reductions in the disparities over time for steroid use were observed between Hispanic and black 8th, 10th, and 12th graders (26-14a, b, and c); male and female 8th, 10th, and 12th graders; and white and black 8th graders (26-14a).

Some objectives showed a variety of changes (decreases and increases) in disparity across population groups. Disparities in cirrhosis (26-2) and drug-induced (26-3) deaths between the white non-Hispanic and Asian or Pacific Islander populations increased, while disparities between males and females declined. The disparity in cirrhosis deaths (26-2) increased for high school graduates relative to the population with at least some college. The disparity in drug-induced deaths (26-3) between persons with less than a high school education and those with at least some college declined. Disparities in disapproval of one to two drinks per day declined between Hispanic and white as well as male and female 8th graders (26-16a), between white and black 10th graders (26-10b), and between male and female 12th graders (26-16c). However, the disparity between Hispanic and white 12th graders relative to black 12th graders increased. Disparities in disapproval of trying marijuana increased between black and white 8th graders (26-16d) and decreased between white and Hispanic 10th graders (26-16e).

An increase in disparity for adult binge drinking was observed between Native Hawaiian or other Pacific Islander and Asian populations (26-11c). Increases in disparities were also seen in adult females exceeding low-risk drinking guidelines (26-13a) for the American Indian or Alaska Native, Hispanic, and white non-Hispanic populations relative to the Asian population. Similarly, increases in disparities were seen in adult males exceeding low-risk drinking guidelines (26-13b) for the American Indian or Alaska Native and Hispanic populations relative to the Asian population.

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