Report Card on the Nation’s Health Shows Progress and Work that Remains

The work of the U.S. Department of Health and Human Services (HHS) Office of Minority Health is rooted in a resounding call sounded more than thirty years ago to address the racial and ethnic health disparities that plague our nation. It was then, in Health, United States 1983 (the annual report card on the nation’s health) that then HHS Secretary Margaret M. Heckler took note of significant disparities that existed between non-Hispanic whites and racial and ethnic minorities despite evidence that showed improvements in the health and longevity of all Americans.

Fueled by this report, in 1984 Secretary Heckler established a task force that within a year developed the Report of the Secretary’s Task Force on Black and Minority Health (also known as the Heckler Report). Released in 1985, by Secretary Heckler, the report provided a detailed analysis of the major factors that contribute to illness and death among racial and ethnic minority populations and signaled a turning point in understanding the extent to which these groups experienced health disparities. The report also led to the creation of the HHS Office of Minority Health to improve minority health and help eliminate these disparities.

Today, the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) continues to prepare the Health, United States report, a consolidation of the most current data on health status and determinants, health care utilization, health care resources, and health care expenditures from federal agency and private entity sources. HHS recently released Health, United States, 2015, which dedicates a portion of its report to trends in health disparities in a Special Feature on Racial and Ethnic Health Disparities, in commemoration of the recent 30th anniversary of the Heckler Report.

Some of the highlights from the Special Feature include:

• The difference between the highest (non-Hispanic black) and lowest (non-Hispanic Asian or Pacific Islander) infant mortality rates among the five racial and ethnic groups narrowed from 9.41 deaths per 1,000 live births in 1999 to 7.21 in 2013.
• During 1999–2014 non-Hispanic black mothers experienced the highest percentage of low-risk cesarean deliveries (29.9 percent in 2014) among the five racial and ethnic groups while non-Hispanic American Indian or Alaska Native mothers experienced the lowest (21.5 percent in 2014).
• Among Hispanic mothers during 1999-2014, Cuban mothers experienced the highest percentage of low-risk cesarean deliveries among the five Hispanic-origin groups (41.4 percent in 2014) while Mexican mothers experienced the lowest (24.1 percent in 2014).
• In 2011–2014 for children and adolescents aged 2–19 years, Hispanic children and adolescents had the highest prevalence of obesity (21.9 percent) and non-Hispanic Asian children and adolescents had the lowest prevalence (8.6 percent).
• The difference for women between the highest (non-Hispanic white) and lowest (non-Hispanic Asian) percentages of current cigarette smokers among racial and ethnic groups narrowed from 17.5 percentage points in 1999 to 13.2 in 2014 (percentages are age-adjusted).
• The difference between the highest and lowest percentage of uninsured adults aged 18-64, narrowed from a difference of 24.9 percentage points in 1999 (Hispanic adults compared with non-Hispanic white adults) to a difference of 19.9 percentage points in the first six months of 2015 (Hispanic adults compared with non-Hispanic Asian adults).
• In 2014 among adults aged 18-64, Hispanic adults had the highest percentage of those not receiving needed dental care in the past 12 months due to cost (15.7 percent) and non-Hispanic Asian adults had the lowest percentage (6.3 percent).

These findings are encouraging as they mark important improvements in some health measures for racial and ethnic minority populations and reflect our collective efforts to improve minority health and build a healthier, more equitable nation. However, significant disparities still exist, and we must remain vigilant in our efforts to end health disparities in America. It is my hope that this report will help reinforce our shared commitment to achieve a nation free of disparities in health and health care.

To view the Health, United States, 2015 report and the Special Feature on Racial and Ethnic Health Disparities, visit http://www.cdc.gov/nchs/hus/index.htm.

J. Nadine Gracia, MD, MSCE is the Former Deputy Assistant Secretary for Minority Health and Director of the Office of Minority Health at the U.S. Department of Health and Human Services.