office of minority health and health disparities (omhd) an overview centers for disease control...

Office of Minority Health and Office of Minority Health and Health Disparities (OMHD)Health Disparities (OMHD)

An OverviewAn Overview

Centers for Disease Control & Prevention (CDC)

What is a “Health Disparity”?What is a “Health Disparity”?Conceptual IssuesConceptual Issues

InequalityInequality

Difference in condition, rankDifference in condition, rank

Lack of equality as of opportunity, Lack of equality as of opportunity, treatment, or statustreatment, or status

Inequity Inequity – Unfair and unjustUnfair and unjust– Unnecessary and avoidableUnnecessary and avoidable

““Health Disparity” in Public Health Disparity” in Public Health – Operational DefinitionHealth – Operational Definition

Quantitative measures: rates, percents, Quantitative measures: rates, percents, means…means…The Quantity that separates a group from The Quantity that separates a group from a reference point on a particular measure a reference point on a particular measure of healthof healthCalls attention to differences in health Calls attention to differences in health between groups between groups regardless of causeregardless of causeCan be measured in absolute or relative Can be measured in absolute or relative termsterms

Health DisparitiesHealth DisparitiesCommunities of ColorCommunities of Color

are Disproportionately Affectedare Disproportionately Affected

Racial and Ethnic Minority Racial and Ethnic Minority PopulationsPopulations

American Indian/Alaska Native (AI/AN)American Indian/Alaska Native (AI/AN)

Asian AmericanAsian American

Black or African AmericanBlack or African American

Hispanic or LatinoHispanic or Latino

Native Hawaiian or Other Pacific Islander Native Hawaiian or Other Pacific Islander (NHOPI)(NHOPI)

Other Populations By . . .Other Populations By . . .

Socio-economic status Socio-economic status

Geography (urban or rural)Geography (urban or rural)

GenderGender

AgeAge

Disability statusDisability status

Risk status related to sex and genderRisk status related to sex and gender

CDC VisionCDC Vision

CDC’s Vision for the 21CDC’s Vision for the 21stst Century is Century is “Health Protection…Health Equity”“Health Protection…Health Equity”

CDC MissionCDC MissionCollaborating to create the expertise, information, and toolsCollaborating to create the expertise, information, and tools

that people and communities need to protect their health that people and communities need to protect their health

– – through health promotion,through health promotion,

prevention of disease, injury and disability,prevention of disease, injury and disability,

and preparedness for new health threatsand preparedness for new health threats

OMHD MissionOMHD MissionThe Office of Minority Health and Health The Office of Minority Health and Health

Disparities (OMHD) aims to accelerate CDC’s Disparities (OMHD) aims to accelerate CDC’s health impact in the U.S population and to health impact in the U.S population and to eliminate health disparities for vulnerable eliminate health disparities for vulnerable

populations as defined by race/ethnicity, socio-populations as defined by race/ethnicity, socio-economic status, geography, gender, age, economic status, geography, gender, age,

disability status, and risk status related to sex disability status, and risk status related to sex and gender, among other populations identified and gender, among other populations identified

to be at-risk for health disparities.to be at-risk for health disparities.

OMHD Guiding PrincipleOMHD Guiding Principle

The future health of the nation will be The future health of the nation will be determined to a large extent by how determined to a large extent by how

effectively we work with communities to effectively we work with communities to eliminate health disparities among those eliminate health disparities among those

populations experiencing gaps in disease, populations experiencing gaps in disease, disability, and death.disability, and death.

What are OMHD Critical Goals?What are OMHD Critical Goals?

(1)(1) Equity in health impactEquity in health impact

(2)(2) Diversity in customer focusDiversity in customer focus

(3)(3) Access to and participation in public health systemsAccess to and participation in public health systems

(4)(4) Participation in the conduct and use of public health Participation in the conduct and use of public health research to solve community wide health problemsresearch to solve community wide health problems

(5)(5) The benefits of global health protection, especially The benefits of global health protection, especially among immigrants and border populationsamong immigrants and border populations

(6)(6) A verifiable commitment to operational efficiency, A verifiable commitment to operational efficiency, program effectiveness, and accountability for public program effectiveness, and accountability for public resources.resources.

What are the OMHD Core What are the OMHD Core Functions?Functions?

1. Maintaining core functions of the 1. Maintaining core functions of the Office Office of Minority Health (OMH)of Minority Health (OMH) without loss without loss of priority, resources, or visibilityof priority, resources, or visibility

2. Developing CDC-wide 2. Developing CDC-wide healthhealth disparities disparities eliminationelimination strategiesstrategies, policies, goals, , policies, goals, and programsand programs


3. Managing 3. Managing health disparities eliminationhealth disparities elimination goalsgoals through scanning, analysis, through scanning, analysis, knowledge management, decision-knowledge management, decision-support systems, and reporting Key support systems, and reporting Key Performance Indicators *, Government Performance Indicators *, Government Performance and Results Act**, Performance and Results Act**, Program Assessment Rating Tool***Program Assessment Rating Tool***

*(GPRA) **(*(GPRA) **( PART) ***(KPI)PART) ***(KPI)


4. Supporting internal and external 4. Supporting internal and external partnershipspartnerships to advance the science, to advance the science, practice, and workforce for eliminating practice, and workforce for eliminating health disparities inside and outside CDChealth disparities inside and outside CDC

5. Synthesizing, disseminating, and 5. Synthesizing, disseminating, and encouraging use of encouraging use of scientific evidencescientific evidence about effective interventions to achieve about effective interventions to achieve health disparities elimination outcomeshealth disparities elimination outcomes

CDC’s Office of Minority CDC’s Office of Minority Health (OMH), 1988Health (OMH), 1988

Established by CDC Director-- 1988Established by CDC Director-- 1988A response to Secretary Heckler’s report A response to Secretary Heckler’s report on excess deaths in certain groups and on excess deaths in certain groups and internal advocacyinternal advocacyCoordination vs. program management Coordination vs. program management Small staff, small budget, no large Small staff, small budget, no large programsprograms

CDC’s OMH, 1988-1998 Major CDC’s OMH, 1988-1998 Major GoalsGoals

Assuring that policies direct activities Assuring that policies direct activities toward minority healthtoward minority healthEnhancing research to reduce the Enhancing research to reduce the disproportionate disease burden in disproportionate disease burden in minority groupsminority groupsDeveloping effective internal and external Developing effective internal and external communication networkscommunication networks

Strategic Redirection of OMH, Strategic Redirection of OMH, 19981998

Executive retreat, agency-wide Executive retreat, agency-wide deliberations on draft paper on new deliberations on draft paper on new vision/policy/strategy/action (1998) vision/policy/strategy/action (1998) Senior Staff reviews, briefings & Senior Staff reviews, briefings & deliberations (1999-2001)deliberations (1999-2001)Policy/Action items approved (Oct 2001)Policy/Action items approved (Oct 2001)

Action Items for Improving Action Items for Improving Minority Health: 2000 - 2005Minority Health: 2000 - 2005

Cross- Cutting ActionsCross- Cutting Actions: Activities each : Activities each CIO should undertakeCIO should undertake

InfrastructureInfrastructure: Mobilizing people, : Mobilizing people, information systems, and resourcesinformation systems, and resources

Program Development and Program Development and Implementation: Implementation: Improving programsImproving programs

Monitoring and AccountabilityMonitoring and Accountability: Tracking : Tracking and assuring qualityand assuring quality

OMH Functions/Priorities OMH Functions/Priorities 2001-20042001-2004

Strategic planning (minority health priorities)Strategic planning (minority health priorities)Policy initiatives (analysis, development)Policy initiatives (analysis, development)Leadership/coordination of minority health initiatives Leadership/coordination of minority health initiatives and Executive Branch activitiesand Executive Branch activitiesSupport for minority-serving institutions of higher Support for minority-serving institutions of higher learninglearningCooperative agreements to conduct research, Cooperative agreements to conduct research, prevention activities, student/faculty developmentprevention activities, student/faculty developmentStudent traineeshipsStudent traineeshipsEpidemiologic studiesEpidemiologic studiesExternal partnerships (technical External partnerships (technical assistance/symposia)assistance/symposia)Direct support to CDC/ATSDR programs (SME)Direct support to CDC/ATSDR programs (SME)

The Futures InitiativeTransforming CDC for a Transforming World

•• InputInput

•• IdeasIdeas

•• ImplementationImplementation

•• ImpactImpact• Outside-in • Interactive• Driven by data • Focused on customers • Strategic direction first,

then structure & processes

•• OutsideOutside--in in •• InteractiveInteractive•• Driven by data Driven by data •• Focused on customers Focused on customers •• Strategic direction first, Strategic direction first,

then structure & processesthen structure & processes

Enhancing Impact on Health Enhancing Impact on Health Disparities: New ProposalsDisparities: New Proposals

Office of Minority Office of Minority Health & Health Health & Health Disparities Disparities

Goal management & Goal management & resource allocation to resource allocation to address disparities address disparities

Accountability Accountability – performance performance

measurementmeasurement– external inputexternal input

OMH Stakeholders Meeting

Office of Minority Health and Health Disparities (OMHD)Office of Minority Health and Health Disparities (OMHD)Organizational UnitsOrganizational Units

Director/ADMHCAPT Walter W. Williams, MD, MPH

Science & Goals Management Karen Bouye, MPH, MS, PhD, Senior Advisor for Research CAPT Ralph T. Bryan, MD, Senior Tribal Liaison Ramal Moonesinghe, PhD, Senior Mathematical Statistician Sarah Berry, Web Developer / Manager Vacant, Epidemiologist Vacant, Communications Specialist

Partnerships & Preparedness

CAPT Pelagie “Mike” Snesrud, Senior Tribal Liaison, AI/AN Vacant, Public Health Analyst AAPI Vacant, Public Health Analyst AA Vacant, Public Health Analyst, HISPPublic Health Preparedness

CAPT Sonja Hutchins, MD, MPH, DrPH, Team Leader Benita Harris, MPH, Senior Public Health Advisor Vacant, Health Communications Specialist Vacant, Health Communications Specialist

Resources & OMHD Operations Theresa Potts, Assistant to the Director Carol Irvin Grant, Secretary Vacant, Lead Management & Program Analyst (FTE) Vacant, Administrative Support Specialist Vacant, Program Specialist Vacant, Administrative Assistant Vacant, Computer Clerk

Strategic Management Team

CAPT Walter W. Williams, MD, MPHTamara J. Kicera, Deputy Director

Benedict I. Truman, MD, MPH, Associate Director for Science Vacant, Assoc. Director Minority Health & Health Disparities Policy

NCIPC

NCZSVBD

Coordinating Office for GLOBAL HEALTH

Coordinating Office for

TERRORISM PREPAREDNESS & EMERGENCY

RESPONSE

Coordinating Center for

ENVIRONMENTALHEALTH &

INJURY PREVENTION

Coordinating Center for

INFECTIOUS DISEASES

Coordinating Center for HEALTH

PROMOTION

Coordinating Center for HEALTH

INFORMATION & SERVICES

CDC Washington Office

Office of the Chief of Public Health

Practice

Office of the Chief Operating Officer

Office of Chief of Staff

Office of Enterprise Communication

Office of Strategy & Innovation

Office of Workforce & Career Development

Office of the Chief Science Officer

Office of the Director

NCPHI

NCHM

NCHS

NCHHSTP

NCIPRD

NCEIC NIOSH

OPHG

NCEHNCBDDD

NCHPDP

CDC Organizational StructureCDC Organizational Structure

Office of Minority Health & Health

Disparities (ADMH)

Population Data and Population Data and Representative MortalityRepresentative Mortality

and Case Ratesand Case Rates

Leading Causes of DeathLeading Causes of DeathAfrican Americans, U.S., 2006African Americans, U.S., 2006

Heart DiseaseHeart Disease

Cancer Cancer

StrokeStroke

Unintentional Unintentional InjuriesInjuries

DiabetesDiabetes

HomicideHomicide

Nephritis, Nephrotic Nephritis, Nephrotic Syndrome, & NephrosisSyndrome, & Nephrosis

Chronic Lower Chronic Lower Respiratory DiseasesRespiratory Diseases

HIV DiseaseHIV Disease

Septicemia Septicemia

Source: CDC, NCHS, Health, United States, 2008, Table 30.

Leading Causes of DeathLeading Causes of DeathHispanic/Latinos, U.S., 2006Hispanic/Latinos, U.S., 2006

Heart DiseaseHeart DiseaseCancer Cancer Unintentional Unintentional Injuries Injuries StrokeStrokeDiabetesDiabetes

Chronic Liver Disease & Chronic Liver Disease & CirrhosisCirrhosisHomicideHomicideChronic Lower Chronic Lower Respiratory DiseaseRespiratory DiseaseInfluenza & PneumoniaInfluenza & PneumoniaCertain Conditions Certain Conditions Originating in the Perinatal Originating in the Perinatal Period Period


Leading Causes of DeathLeading Causes of DeathAmerican Indian/Alaska Natives, U.S., 2006American Indian/Alaska Natives, U.S., 2006

Heart DiseaseHeart Disease

Cancer Cancer

Unintentional Unintentional Injuries Injuries

Diabetes Diabetes

Chronic Liver Chronic Liver Disease & CirrhosisDisease & Cirrhosis

StrokeStroke


SuicideSuicide


Influenza & Pneumonia Influenza & Pneumonia


Leading Causes of DeathLeading Causes of DeathAsian or Pacific Islanders, U.S., 2006Asian or Pacific Islanders, U.S., 2006

Cancer Cancer

Heart Disease Heart Disease

StrokeStroke

Unintentional Unintentional InjuriesInjuries

DiabetesDiabetes


Influenza & PneumoniaInfluenza & Pneumonia


SuicideSuicide

Alzheimer’s DiseaseAlzheimer’s Disease


Populationof the United States by Race & Hispanic Origin:

2008 & Projected 2050

46

15

1.6 25.1

9.215

30

66

14

0

10

20

30

40

50

60

70

80

90

100

2008 2050

% P

erce

nt o

f Tot

al U

.S. P

opul

atio

n Non-Hispanic White

African American

American Indian / Alaska Native

Asian

Hispanic/Latino

Source: U.S. Census Bureau, 2008 National Population Projections, August 14, 2008http://www.census.gov/Press-Release/www/releases/archives/population/012496.html

Source: Health, United States, 2006. http://www.cdc.gov/nchs/data/hus/hus06.pdf#summary Table 19.

Infant MortalityRates per 1,000 Live Births by Detailed Race & Hispanic

Origin of Mother: U.S.,2002

7.05.8 5.8

13.9 13.8

8.6

4.8

3.0

4.95.7

9.6

4.75.6 5.4

8.2

3.7

5.1

7.1

0

5

10

15

All Rac

es

Whi

te N

on-H

ispan

icW

hite

Africa

n Am

erica

n Non

-Hisp

anic

Africa

n Am

erica

n

Amer

ican

India

n/Ala

ska

Native

Asian/

Pacific

Isla

nder

Chines

e

Japa

nese

Filip

ino

Hawaii

an

Other

Asia

n or

Pac

ific Is

lande

r

Hispan

ic

Mex

ican

Puerto

Rica

n

Cuban

Centra

l & S

outh

Am

erica

n

Other

& U

nkno

wn Hisp

anic/

Latin

o

Infa

nt

Mo

rta

lity

Ra

te p

er

1,0

00

Liv

e B

irth

s

Infant MortalityRates per 1,000 Live Births by Detailed Race & Hispanic

Origin of Mother: U.S.,2005

6.95.8 5.7

13.6 13.3

8.1

4.95.6 5.5

8.3

4.4 4.7

6.4

0

5

10

15

All Rac

es

Whit

e Non

-Hisp

anic

Whit

e

Africa

n Am

erica

n Non

-Hisp

anic

Africa

n Am

erica

n

Amer

ican

India

n/Alas

ka N

ative

Asian/

Pacific

Islan

der

Hispan

ic

Mex

ican

Puerto

Rica

n

Cuban

Centra

l & S

outh

Am

erica

n

Other

& U

nkno

wn Hisp

anic/

Latin

o

Infa

nt

Mo

rta

lity

Ra

te p

er

1,0

00

Liv

e B

irth

s

Source: CDC, NCHS, Health, United States, 2008, Table 18 http://www.cdc.gov/nchs/data/hus/hus08.pdf

Infant Death Under 1 Year Rates per 1,000 Live Births by Race & Hispanic

Origin: U.S.,2005

6.95.7 5.7

13.7

5.8

0

5

10

15

All Races Non-HispanicWhite

White AfricanAmerican

Hispanic

Ag

e-A

dju

sted

Dea

th R

ate

per

1,0

00 I

nfa

nts

Source: National Vital Statistics Report, 56(16), 6/11/08: Deaths: Preliminary Data for 2006, Table 4, p22 http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_16.pdf

Sudden Infant Death Syndrome (SIDS)Rates per 100,000 Live Births by Race & Hispanic

Origin: U.S.,2006

50.3 50.742.4

99.1

23.5

0

20

40

60

80

100



Hispanic

Ag

e-A

dju

sted

Dea

th R

ate

per

100

,000

Liv

e B

irth

s

Source: National Vital Statistics Report, 56(16), 6/11/08: Deaths: Preliminary Data for 2006, Table 8, p32 http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_16.pdf

Maternal Mortalityfor Complications of Pregnancy, Childbirth, & the Puerperium

Age-Adjusted Death Rates per 100,000 Persons by Race & Hispanic Origin: U.S.,

2005

12.49.6 9.1

31.7

8.2

0

5

10

15

20

25

30

35



Hispanic

Ag

e-A

dju

ste

d M

ate

rna

l M

ort

ali

ty R

ate

pe

r 1

00

,00

0 P

ers

on

s

Source: CDC, NCHS, Health, United States, 2008, Table 42.http://www.cdc.gov/nchs/data/hus/hus08.pdf

Source: Health, United States, 2007. http://www.cdc.gov/nchs/data/hus/hus07.pdf#029 Table 29.

All CausesAge-Adjusted Death Rates per 100,000 Persons by Race &

Hispanic Origin: U.S.,2005

798.8 785.3

1016.5

663.4

440.2

590.7

0

200

400

600

800

1000

1200

All Races White AfricanAmerican

AmericanIndian/Alaska

Native

Asian/PacificIslander

Hispanic

Ag

e-A

dju

ste

d D

ea

th R

ate

pe

r 1

00

,00

0 P

ers

on

s


Heart Disease, Cancer, & StrokeAge-Adjusted Death Rates per 100,000 Persons by Race &


211.1 207.8

271.3

141.8

113.3

157.3

183.8 182.6

222.7

123.2110.5

122.8

46.6 44.7

65.2

34.8 38.6 35.7

0

50

100

150

200

250

300


AmericanIndian/ Alaska

Native

Asian/ PacificIslander

Hispanic

Age

-Adj

uste

d D

eath

Rat

e pe

r 10

0,00

0 Per

sons

Heart DiseaseCancerStroke


DiabetesAge-Adjusted Death Rates per 100,000 Persons by Race &


24.622.5

46.9

41.5

16.6

33.6

0

5

10

15

20

25

30

35

40

45

50



Native


Hispanic

Ag

e-A

dju

ste

d D

ea

th R

ate

pe

r 1

00

,00

0 P

ers

on

s


Motor Vehicle-Related InjuriesAge-Adjusted Death Rates per 100,000 Persons by Race &


15.2 15.614.5

24.8

7.6

14.7

0

5

10

15

20

25



Native


Hispanic

Ag

e-A

dju

ste

d D

ea

th R

ate

pe

r 1

00

,00

0 P

ers

on

s


Human Immunodeficiency Virus (HIV) Disease Age-Adjusted Death Rates per 100,000 Persons by Race &

Hispanic Origin: U.S., 2005

4.2

2.2

19.4

2.7

0.6

4.7

0

5

10

15

20



Native


Hispanic

Ag

e-A

dju

ste

d D

ea

th R

ate

pe

r 1

00

,00

0 P

ers

on

s


Chronic Liver Disease & CirrhosisAge-Adjusted Death Rates per 100,000 Persons by Race &


9.0 9.27.7

22.6

3.6

13.9

0

5

10

15

20

25



Native


Hispanic

Ag

e-A

dju

ste

d D

ea

th R

ate

pe

r 1

00

,00

0 P

ers

on

s

Tuberculosis (TB) Case RatesAge-Adjusted Case Rates Per 100,000 Persons by Race &

Ethnicity: U.S.,2007

0.8 1.1

9.3

6.0

25.8

8.4

23.4

0

5

10

15

20

25

30

Multi Racial non-HispanicWhite

non-HispanicBlack

American Indian/ Alaska Native

(AI/ AN)

Asian American Hispanic/Latino Native Hawaiian& Other Pacific

Islanders(NHOPI)

Age

-Adj

uste

d Cas

es p

er 100

,000

Per

sons

Source: CDC, MMWR, March 21, 2008 / 57(11);281-285, Trends in TB, US, 2007, Table:

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5711a2.htm

Acute Hepatitis B (HBV) Incidence Case Rates Age-Adjusted Incidence Case Rates per 100,000 Persons by

Race & Ethnicity: U.S.,2006

1.1

2.3

1.21.1

0

1

2

3

White non-Hispanic Black non-Hispanic Asian/ Pacific Islander Hispanic/ Latino

Age

-Adj

uste

d Cas

es p

er 100

,000

Per

sons

Source: CDC MMWR, V57, SS2, March 21, 2008, p5. http://www.cdc.gov/mmwr/PDF/ss/ss5702.pdf

SourcesSourcesCenters for Disease Control and Prevention (CDC):Centers for Disease Control and Prevention (CDC):

National Center for Health Statistics (NCHS)National Center for Health Statistics (NCHS)

Health U.S., 2008 http://www.cdc.gov/nchs/data/hus/hus08.pdfHealth U.S., 2008 http://www.cdc.gov/nchs/data/hus/hus08.pdf

National Vital Statistics Report National Vital Statistics Report http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_16.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_16.pdf

National Center for HIV, STD, and TB Prevention (NCHSTP)National Center for HIV, STD, and TB Prevention (NCHSTP)

National Center for Injury Prevention and Control (NCIPC)National Center for Injury Prevention and Control (NCIPC)

MMWR

March 21, 2008 / 57 (SS2): 5. http://www.cdc.gov/mmwr/PDF/ss/ss5702.pdf

March 21, 2008 / 57(11); 281-285. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5711a2.htm

National Institute on Alcohol Abuse and AlcoholismNational Institute on Alcohol Abuse and Alcoholism

National Women’s Health Information Center (NWHIC)National Women’s Health Information Center (NWHIC)

U.S. Census BureauU.S. Census Bureau


Heart DiseaseAge-Adjusted Death Rates per 100,000 Persons by Race &


211.1 207.8

271.3

141.8

113.3

157.3

0

50

100

150

200

250

300



Native


Hispanic

Ag

e-A

dju

ste

d D

ea

th R

ate

pe

r 1

00

,00

0 P

ers

on

s


CancerAge-Adjusted Death Rates per 100,000 Persons by Race &


183.8 182.6

222.7

123.2110.5

122.8

0

50

100

150

200

250



Native


Hispanic

Ag

e-A

dju

ste

d D

ea

th R

ate

pe

r 1

00

,00

0 P

ers

on

s


StrokeAge-Adjusted Death Rates per 100,000 Persons by Race &


46.644.7

65.2

34.838.6

35.7

0

10

20

30

40

50

60

70



Native


Hispanic

Ag

e-A

dju

ste

d D

ea

th R

ate

pe

r 1

00

,00

0 P

ers

on

s


Prostate CancerAge-Adjusted Death Rates per 100,000 Persons by Race &


24.522.6

53.3

17.6

10.4

18.5

0

5

10

15

20

25

30

35

40

45

50

55

60



Native


Hispanic

Ag

e-A

dju

ste

d D

ea

th R

ate

pe

r 1

00

,00

0 P

ers

on

s


Trachea, Bronchus & Lung CancerAge-Adjusted Death Rates per 100,000 Persons by Race &


52.6 53.1

58.4

34.1

25.722.4

0

5

10

15

20

25

30

35

40

45

50

55

60



Native


Hispanic

Ag

e-A

dju

ste

d D

ea

th R

ate

pe

r 1

00

,00

0 P

ers

on

s


Unintentional InjuriesAge-Adjusted Death Rates per 100,000 Persons by Race &


39.1 40.1 38.7

54.7

17.9

31.3

0

5

10

15

20

25

30

35

40

45

50

55

60



Native


Hispanic

Ag

e-A

dju

ste

d D

ea

th R

ate

pe

r 1

00

,00

0 P

ers

on

s


Chronic Lower Respiratory DiseaseAge-Adjusted Death Rates per 100,000 Persons by Race &


43.245.4

30.629.1

14.9

19.3

0

5

10

15

20

25

30

35

40

45

50



Native


Hispanic

Ag

e-A

dju

ste

d D

ea

th R

ate

pe

r 1

00

,00

0 P

ers

on

s


Breast CancerAge-Adjusted Death Rates per 100,000 Persons by Race &


24.1 23.4

32.8

15.2

12.2

15.0

0

5

10

15

20

25

30

35



Native


Hispanic

Ag

e-A

dju

ste

d D

ea

th R

ate

pe

r 1

00

,00

0 P

ers

on

s


Colon, Rectum & Anus CancerAge-Adjusted Death Rates per 100,000 Persons by Race &


17.5 16.9

24.8

12.011.2

12.4

0

5

10

15

20

25



Native


Hispanic

Ag

e-A

dju

ste

d D

ea

th R

ate

pe

r 1

00

,00

0 P

ers

on

s


Influenza & PneumoniaAge-Adjusted Death Rates per 100,000 Persons by Race &


20.3 20.221.7

20.4

15.516.8

0

5

10

15

20

25



Native


Hispanic

Ag

e-A

dju

ste

d D

ea

th R

ate

pe

r 1

00

,00

0 P

ers

on

s


SuicideAge-Adjusted Death Rates per 100,000 Persons by Race &


10.9

12.0

5.2

11.7

5.25.6

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6.1

3.7

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2.9

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20

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Review Questions (Developed by the Review Questions (Developed by the Supercourse team)Supercourse team)

• What is the definition of What is the definition of disparities?disparities?

•Why does the American Why does the American Indians/Alaskan natives have a Indians/Alaskan natives have a lower death rate than whites or lower death rate than whites or African Americans?African Americans?

office of minority health and health disparities (omhd) an overview centers for disease control...

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