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 8-2), which displays information about disparities among select populations for which data were available for assessment.

Data were available to assess disparities for harmful air pollutants (8-1a through f), elevated blood lead levels in children (8-11), homes tested for radon (8-18), and lead-based paint testing (8-22). Assessing the level of disparity and change in disparity is challenging when data are sparse, not obtained in a systematic manner, or not reported with a level of precision necessary to make distinctions between select populations. The EPA Aerometric Information Retrieval System, used as the data source for objective 8-1, was not designed to assess health effects in a systematic manner but rather to address existing or suspected air quality problems in general. Data were sparse for objectives 8-11, 8-18, and 8-22.

Notwithstanding the limitations imposed by the data, some general observations on the level of disparities and change in disparities can be made. Elevated ozone (8-1a) is an air quality problem most associated with urban and metropolitan areas and the related high density of motor vehicles and industrial development. The American Indian or Alaska Native population had the lowest and best rate for elevated ozone (8-1a) among racial and ethnic populations. The Asian population, persons of two or more races, and the Hispanic population had rates 117 percent to 188 percent higher than the American Indian or Alaska Native population (best) for elevated ozone (8-1a). Between 1997 and 2001, the rate for the American Indian or Alaska Native population declined, while the rate for the Hispanic population remained constant; hence, disparity between these two populations increased.

Particulate matter (8-1b) is a problem most associated with urban and metropolitan areas. The black non-Hispanic population had the lowest and best rate for exposure to particulate matter. Rates for the other populations, with the exception of the white non-Hispanic population, were at least twice that of the best population. While exposure rates declined for all populations between 1997 and 2001, the rate of decline for the black non-Hispanic population exceeded the rates of the other racial and ethnic populations, resulting in the increases in disparities seen in Figure 8-2.

A similar situation was found with carbon monoxide (8-1c). The white non-Hispanic population had the best rate. Rates of the Asian population, persons of two or more races, and the Hispanic population were at least twice the rate of the white non-Hispanic population. As with particulate matter, rates of all populations declined between 1997 and 2001. The rate of the best group declined at a faster pace than all other racial and ethnic populations, except for the Native Hawaiian or other Pacific Islander population, resulting in a decrease in disparity between that group and the white non-Hispanic population and increases in disparity between all other populations and the white non-Hispanic population. All populations, except for the Native Hawaiian or other Pacific Islander population, reported the same exposure level (1 percent) to sulfur dioxide (8-1e). The Native Hawaiian or other Pacific Islander population reported an exposure level three times that of the other populations. As indicated above, the targets of zero percent for persons exposed to nitrogen dioxide (8-1d) and lead (8-1f) were achieved in 2001. As a result, all populations had a best rate of zero, and no disparities were observed.

While disparities remained quite large (greater than 1,000 percent) between the urban and rural populations for exposure to ozone (8-1a), particulate matter (8-1b), and carbon monoxide (8-1c), there were also substantial (25 to 800 percentage points) declines in these disparities. At the beginning of the decade, rates of the rural population were low (0 percent to 4 percent) and changed very little. Since there is little change in the rural population, as the rates for exposure to these pollutants experienced by the urban population decline, so do the relative disparities.

Data were not sufficient to compare the blood lead levels in children between populations (8-11). The black non-Hispanic population had the best rate for pre-1950s homes tested for lead-based paint (8-22). Disparity between the Hispanic population and the best group declined between 1998 and 2002.

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