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 13-2), which displays information about disparities among select populations for which data were available for assessment.

Data were available to assess disparities for six of the HIV-related objectives and subobjectives. Among racial and ethnic populations, the black non-Hispanic population had the best rates for condom use (13-6a and b). The American Indian or Alaska Native population had the best rate for HIV testing of TB patients (13-11). This group was almost twice as likely to receive testing as was the Asian or Pacific Islander population and 50 percent more likely to be tested than persons of Hispanic origin. Although the testing rates increased among all racial and ethnic populations between 1998 and 2002, the disparities between the American Indian or Alaska Native population and the Asian or Pacific Islander and Hispanic populations increased. The reason for this increase is that the rate of the American Indian or Alaska Native population increased at a much faster pace than the testing rates of the Asian or Pacific Islander and Hispanic populations.

The Asian or Pacific Islander population had the best rates of new cases of AIDS per 100,000 persons aged 13 years and older (13-1) and of HIV-infected persons surviving 3 or more years after AIDS diagnosis (13-16). Significant disparities in new cases of AIDS occurred in 2003. The black non-Hispanic population had a rate that was 15 times the rate of the Asian or Pacific Islander (best) population. The rate for the Hispanic population was more than five times the best rate, and the rate for the American Indian or Alaska Native population was twice the best rate. Between 1998 and 2003, disparities between the black non-Hispanic and Hispanic populations and the Asian or Pacific Islander population decreased by more than 100 percentage points. The disparity between the white non-Hispanic and the Asian or Pacific Islander population decreased by about 45 percentage points. The white non-Hispanic population had the best rate for HIV-infection deaths (13-14). The rate of the black non-Hispanic population was 10 times the white non-Hispanic rate, while the rate of the Hispanic population was almost three times as great as the white non-Hispanic rate. The disparity between these two groups decreased between 1999 and 2002.

Women had better rates for new AIDS cases (13-1) and HIV-infection deaths (13-14) than men. The rates for men were more than double those for women. Between 1999 and 2002, the disparity between males and females in HIV-infection deaths declined by about 30 percent. HIV-infected men had better rates for surviving 3 or more years after AIDS diagnosis (13-16) than had HIV-infected women.

Best group rates for varying objectives showed a broad distribution. Persons with at least some college had the best rates for condom use (13-6a and b) and HIV-infection deaths (13-14). The HIV-infection death rates for persons with less than a high school education and high school graduates were more than three times the rate of persons with at least some college. While HIV-infection death rates declined for all education groups between 1999 and 2002, the disparities between the group with at least some college and the other education groups increased. This increase occurred because the rate of the population with at least some college declined at a faster pace than the rates of the other education groups.

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