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Health Topics
Addressing Health Disparities
 In
the United States racial and ethnic minorities, as well as sexual minority
populations, suffer disproportionately from preventable diseases and
conditions, many of which result from health-related behaviors that are
established during childhood and adolescence. These behaviors include
physical inactivity, poor nutrition, tobacco use, sexual risk behaviors, and
poor asthma management.
Addressing health disparities is a central focus of the strategic plans
for both the U.S. Department of Health and Human Services (DHHS) and the
Centers for Disease Control and Prevention (CDC). An overarching goal for
DHHS’s Healthy People 2010, a set of health objectives for the
nation, is eliminating health disparities, and two of CDC’s four health
protection goals directly address the importance of reaching at-risk
populations:
- Healthy People in Every Stage of Life—All people, and
especially those at greater risk of health disparities, will
achieve their optimal lifespan with the best possible quality of health
in every stage of life.
- Healthy People in Healthy Places—The places where people
live, work, learn, and play will protect and promote their health and
safety, especially those at greater risk of health disparities.
Investing in Our Nation’s Future:
Addressing Health Disparities Among Youth
Culturally appropriate school programs that address risk behaviors among
youth, especially when coordinated with community efforts, could improve the
health of populations at risk for health disparities, and the health of the
nation as a whole. CDC’s Division of Adolescent and School Health (DASH),
whose mission is preventing the most serious health risks among youth,
incorporates efforts to address health disparities among at-risk communities
in every aspect of its work.
Funding Programs
Funded state and local agencies are encouraged to implement strategies to
reduce disparities among populations that may be disproportionately affected
by health-related risks and problems. Likewise, funded nongovernmental
organizations (NGOs) are asked to address health disparities, and
incorporate culturally and linguistically appropriate activities and
resources into their work. In addition, DASH created separate funding
categories to help NGOs provide capacity-building assistance to agencies and
organizations serving youth at high risk for HIV infection: young men who
have sex with men, especially African American and Latino males; African
American and Latina females; youth in juvenile justice facilities or
alternative schools; and runaway and homeless youth.
Examples of CDC DASH-funded Activities
- South Dakota supports a special evaluation project with
students attending elementary schools on the Pine Ridge Indian
Reservation to determine best practices for increasing fruit and
vegetable consumption.
- The Indiana Department of Education is assisting in the
development of strategies and policies to reduce disparities among
youth, including African American youth, in six communities with the
most reported HIV/AIDS cases.
- Florida’s Broward County School System collaborates with the health
department and other community-based organizations (CBOs) to educate
high-risk, out-of-school youth and those in the juvenile justice system
on HIV prevention. They also work with partners to provide culturally
competent presentations for African American, Latino, and Haitian
students and parents.
- Advocates for Youth (AFY) has partnered with Black
Entertainment Television to develop HIV prevention messages in
television programming. In addition, AFY will provide resources,
technical assistance, training, and seed grants to build the capacity of
societal institutions that influence youth behavior by providing
culturally relevant, science-based HIV prevention strategies for young
African American and Latina women.
- The AIDS Alliance for Children, Youth, and Families is
increasing the capacity of service providers—as well as CBOs serving
youth at high risk for HIV infection—to plan, deliver, and evaluate
scientifically sound and medically accurate HIV protection programs for
African American and Latina teen girls. This project also includes a
teen advocacy component focusing on health promotion and HIV prevention.
- Girls Incorporated, with many of its affiliate organizations
serving a majority of Latina and/or African American girls, has
developed a variety of resources, professional trainings, workshops, and
mini-grant opportunities for affiliates to strengthen their capacities
to address HIV prevention and related health issues, and to strengthen
community partnerships.
- The American Psychological Association (APA) developed a
training manual for school health and mental health professionals on how
to better reach lesbian, gay, and bisexual youth with HIV prevention
education and positive health information. In addition, APA is providing
professional development and other technical assistance to youth-serving
organizations nationwide to address HIV prevention, especially among
young African American and Latino males who have sex with men.
- The United Negro College Fund Special Programs Corporation is
providing capacity-building activities for historically black colleges
and universities to develop, implement, and sustain campus-wide programs
and policies to promote prevention of HIV/AIDS and other health risks.
Plans include increasing the number of courses containing HIV/AIDS
prevention content and developing a social marketing campaign featuring
culturally and linguistically appropriate HIV/AIDS prevention messages
for college-age youth.
Surveillance, Evaluation, and Research
- The Youth Risk Behavior Surveillance System monitors priority
health risk behaviors that contribute to the leading causes of death,
disability, and social problems among youth in the United States. The
national Youth Risk Behavior Survey, conducted every 2 years,
oversamples African American and Latino youth to enable separate
analyses for these subgroups. The state, territorial, and local Youth
Risk Behavior Surveys use samples representative of the racial/ethnic
groups in each jurisdiction.
- The Bureau of Indian Education Youth Risk Behavior Survey is
conducted every 3 years to collect information and data on students in
Bureau-funded schools. In addition, the Navajo Nation (working with the
Indian Health Service) has conducted the Youth Risk Behavior Survey
among middle school and high school students attending public and
private schools on the Navajo Reservation.
- School Health Profiles are surveys conducted by states and
large urban school districts that provide information on current school
health policies and programs such as health education; physical
education; and policies related to HIV prevention, tobacco-use
prevention, violence prevention, and physical activity. Many large urban
school districts, whose student populations are composed largely of
racial and ethnic minorities, conduct School Health Profiles, and the
data collected help inform their planning processes.
- Linking Lives is an evaluation of the effectiveness of a
parent-based intervention designed as a supplement to school-based
programs for reducing sexual risk behaviors and preventing tobacco use
among African American and Latino adolescents in New York City.
- The Seattle Schools Climate Study is an evaluation of the
environments in selected Seattle middle and high schools and the role
gay/straight alliances play in creating a safer environment for all
students.
- All About Youth is an evaluation of the effectiveness of
comparable sexual risk avoidance and sexual risk reduction interventions
among predominantly Latino and African American middle school students
in Houston compared with a control group.
- Healthy Passages is a longitudinal, multi-site study to
understand and identify, among a cohort of youth including African
American and Latino youth, the determinants of health risk behaviors and
how those determinants vary based on gender, race/ethnicity, and
socioeconomic background.
CDC's DASH Disparities Task Force
Overarching Strategies
DASH has established a Task Force on health disparities that brings
together representatives from state and local education agencies, and major
national education and health organizations. The Task Force’s strategic
approach to reducing health disparities is threefold:
- Raise awareness in identifying and addressing health disparities.
- Identify key issues that national public health agencies need to
consider when crafting program announcements or developing other
mechanisms for funding.
- Improve the quality of existing resources, programs, and services to
more effectively address the needs and priorities of communities of
color.
Current Priority Activities
To help reduce health disparities among school-aged youth, the Task Force
has identified three priority activities:
- Providing professional development for grantees and policy-makers on
the prevalence of health disparities, cultural awareness, promising
practices, and lessons learned.
- Developing a curriculum analysis tool for cultural competence and
awareness of cultural differences.
- Creating a Web-based repository of resources and materials on health
disparities.
For More Information
Youth Risk Behavior
Survey. Presentation slides and fact sheets are available, providing
information on racial/ethnic differences in health risk behaviors among
youth.
Proceedings and
Executive Summary of the Surgeon General's Workshop on Improving Health
Literacy, held September 7, 2006, at the National Institutes of Health, Bethesda, MD. On September 7, 2006, Acting Surgeon General Kenneth Moritsugu
held a Surgeon General's Workshop on Improving Health Literacy. The goal of
the workshop was to present the state of the science in the field of health
literacy from a variety of perspectives, including those of health care
organizations and providers, the research community, and educators. During
the course of the one-day workshop, participants identified the public
health consequences of limited health literacy and established an evidence
base for taking action.
Documents on this page are available in
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