Health Disparities

Developing Definitions

Definitions of health disparities in the United States can be traced as far back as 1985, when the Secretary's Task Force on Black and Minority Health [Page 608]of the Department of Health and Human Services raised awareness of the health differences between minority groups and the White majority population in the country. The task force was a group of experts formed by the U.S. government to examine minority health problems comprehensively. It uses excess deaths as the primary indicator of a disparity and defines excess deaths as “the difference between the number of deaths actually observed in a minority group and the number of deaths that would have occurred in that group if the minority group experienced the same death rates for each age and sex as the White population.”

The task force report was motivated by the release of the Department of Health and Human Services report, Health, United States 1983, in 1984. Although this report was the eighth of its kind on the health status of the nation, it was the first report to go beyond the Black/White dichotomy by presenting health status information according to ethnicity, namely for Hispanics and non-Hispanics. Moreover, information on Mexican Americans, Puerto Ricans, and Cubans was included whenever the data were available. This report underscored that although the health of the overall population had improved significantly, Blacks and other minority groups were experiencing a disproportionate burden of disease and death.

This differential between minority and majority in disease and death continued into the next decade, as underscored by Healthy People 2000: National Health Promotion and Disease Prevention Objectives in September 1990 and by Healthy People 2010 in January 2000—nearly 10 years later. These reports suggest that the health status of U.S. residents has been improving over time but that this improvement has been unequal across groups. In fact, because of this unequal improvement among groups of the population, the differences between racial/ethnic and socioeconomic groups have increased over time. These differences led to one of the two overarching goals of Healthy People 2010, namely, “to eliminate health disparities among segments of the population, including differences that occur by gender, race/ethnicity, education or income, disability, geographic location, or sexual orientation.”

...