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 25-2), which displays information about disparities among select populations for which data were available for assessment.

Among racial and ethnic groups, the white non-Hispanic population generally had the best rate for STD objectives. For both gonorrhea (25-2) and primary and secondary syphilis (25-3), the Asian or Pacific Islander population had the best rates.

The white non-Hispanic population had the best congenital syphilis rate (25-9), with disparities of more than 100 percent for the American Indian or Alaska Native, Asian, and Native Hawaiian or other Pacific Islander, Hispanic or Latino, and black non-Hispanic populations. Between 1997 and 2003, disparities increased for the American Indian or Alaska Native, Asian or Pacific Islander, and Hispanic populations and decreased for the black non-Hispanic population. These changes in disparity occurred in the context of substantial reductions in congenital syphilis rates overall. Rates declined for the black non-Hispanic population by 72 percent and by smaller proportions for the other populations.

The Asian or Pacific Islander population had the best rates for new cases of gonorrhea (25-2a), new cases of gonorrhea in women (25-2b), and new cases of primary and secondary syphilis (25-3). Between 1997 and 2003, the rates for the Asian or Pacific Islander population increased for each of these objectives, contributing to the reduction in disparities experienced by the American Indian or Alaska Native, Hispanic or Latino, and the black non-Hispanic populations. Although the rates for most of the other populations also increased for these three objectives, the rates for the black non-Hispanic population declined.

The disparities in the proportion of females aged 15 to 24 years with chlamydia who attended family planning clinics (25-1a) decreased for the Native Hawaiian or other Pacific Islander, Hispanic, and black non-Hispanic populations, compared with the white non-Hispanic (best) population. The declines in disparity occurred, in part, because the best group moved away from the target at a faster pace than the other groups. Disparity between the Asian population and the best group increased. The proportion of black non-Hispanic females with chlamydia who attended STD clinics was almost three times that of white non-Hispanic females.

Decreasing disparities in chlamydia among females who attended STD clinics (25-1b) were seen between the white non-Hispanic (best) population and the American Indian or Alaska Native, Hispanic, and black non-Hispanic populations. Declines in chlamydia disparity among males aged 15 to 24 years who attended STD clinics (25-1c) were seen between the white non-Hispanic (best) population and the American Indian or Alaska Native, Native Hawaiian or other Pacific Islander, and Hispanic populations. Disparities increased between the white non-Hispanic population (best) and the Asian and black non-Hispanic populations.

Males had better rates than females for new cases of gonorrhea (25-2a), genital herpes (25-4), abstinence in the past 3 months (25-11b), and condom use at last intercourse (25-11c). The proportion of females aged 20 to 29 years old with genital herpes (25-4) was more than double that of males. Compared with males, females had a better rate for primary and secondary syphilis (25-3). The largest disparity for males compared with females was noted for cases of primary and secondary syphilis (25-3). Males demonstrated an increase in disparity of more than 100 percentage points from 1997 to 2003. In 2003, the syphilis rate for males was more than five times that of the rate for females.

Objectives also demonstrated disparities between income and education levels. The middle/high-income population had the lowest proportion in persons aged 20 to 29 years with genital herpes (25-4). Treatment for pelvic inflammatory disease in females aged 15 to 44 years (25-6) was best for persons with at least some college.

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