7.4 Elimination of Racial/Ethnic Health Disparities in Health Outcomes

Racial/ethnic disparities in health outcomes have multiple determinants that include unequal living conditions (including safety), unequal access to resources and services that preserve health, and discrimination.  Social and economic disparities reflect historic patterns of lower incomes, higher unemployment, and lower educational attainment levels among people of color than among whites.  People of color in many Boston neighborhoods also face higher levels of exposure to environmental toxins and other health risks.

In order to understand and eventually eliminate health disparities in Boston, Mayor Thomas M. Menino appointed aTask Force on Racial and Ethnic Health Disparities  which has issued both a data report and a Blueprint outlining twelve recommendations for health care and environmental and societal change.  The data report concluded that, across the lifespan, Boston’s racial and ethnic groups have strikingly disparate risks of illness and death.  Black Bostonians, as a group, have worse health than all other Bostonians on a broad range of indicators, with higher rates of preterm birth, overweight, diabetes, hypertension, heart disease, hospitalization, cancer mortality, and premature death from a variety of conditions.  Latino Bostonians, as a group, have worse health than white residents on certain health indicators. Examples include asthma hospitalization and mortality, HIV, overweight, diabetes, and mental illness. Asian Bostonians, as a group, have greater barriers to care than whites and higher rates of tuberculosis and hepatitis B. The report also found that neither generally-lower incomes and education levels of black and Latino Bostonians, nor differences in personal behaviors such as smoking, adequately explain the City’s health disparities.

At the state level, theCommission to End Racial and Ethnic Health Disparitiessimilarly found in August 2007 that Black Commonwealth residents suffer worse health status than all other residents, including higher rates of infant mortality, inadequate prenatal care, and a higher mortality rate for heart disease, cancer, stroke, diabetes, HIV/AIDS, homicide and motor vehicle accidents.

These disparities highlight the need for adequately funded, culturally competent programs to address community needs from infancy to old age with emphasis on consistent preventive and primary care.