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 2-2), which displays information about disparities among select populations for which data were available for assessment.

Disparities exist for many of the arthritis, osteoporosis, and chronic back conditions objectives. In a comparison of disparities among racial and ethnic populations, the white non-Hispanic population had the best rates for activity limitations due to arthritis (2-2), unemployment rate (2-5a), and effect of arthritis on paid work (2-5b). The white population had the best rate for racial differences in total knee replacement (2-6). The black non-Hispanic population had the best rates for counseling adults with arthritis for weight reduction (2-4a) and exercise (2-4b). The Asian population had the best rate for mean level of joint pain (2-1). The Hispanic population had the best rates for activity limitations due to chronic back conditions (2-11).

In a comparison of disparities among females and males, women had better rates than men for counseling of adults with arthritis for weight reduction (2-4a) and exercise (2-4b), and for seeing a health care provider (2-7). Men had a better rate than women for unemployment rate (2-5a).

Among populations by education, persons with at least some college had the best rates for mean level of joint pain (2-1), activity limitations due to arthritis (2-2), counseling for adults with arthritis for exercise (2-4b), unemployment rate (2-5a), effect of arthritis on paid work (2-5b), seeing a health care provider (2-7), cases of osteoporosis (2-9), and activity limitations due to chronic back pain conditions (2-11).

In a comparison of disparities among populations by income, the middle/high-income population had the best rates for most of the objectives and subobjectives, including mean level of joint pain (2-1), activity limitations due to arthritis (2-2), unemployment rate (2-5a), effect of arthritis on paid work (2-5b), and activity limitations due to chronic back conditions (2-11). The poor population had the best rate for counseling adults with arthritis for weight reduction (2-4a).

Some objectives and subobjectives demonstrated greater disparities than others. While the best groups for unemployment rate (2-5a) and effect of arthritis on paid work (2-5b) were generally consistent with those for other arthritis objectives, the disparities were particularly high (often 100 percent or more) for those with lower education and lower income. Progress toward eliminating disparities depends on raising awareness of the impact of arthritis and the availability of effective interventions that are currently underutilized in these populations.

Large disparities exist for activity limitations due to chronic back conditions (2-11). The Hispanic population had the best rate, and the rate of persons with two or more races was approximately 175 percent higher than the rate of the Hispanic population. Persons with less than a high school education had more than twice the rate of persons with at least some college education and 50 percent higher than the rate of high school graduates. The disparity between high school graduates and persons with at least some college increased by about 25 percentage points between 1997 and 2003. Among the poor and near-poor population groups, the rates for activity limitations were more than twice that of the middle/high-income population.

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