Health Disparities from Knowledge to Action课件.ppt

Health Disparities From knowledge to action Overview of Disparities Overview of Disparities Minority Americans report widespread patient-physician communication differences Minority Americans are more likely to feel treated with disrespect when obtaining health care Though the gap is closing disparities persist in satisfaction with primary and secondary care Overview of Disparities Overview of Disparities Minority Americans have worse health status and more chronic conditions Minority Americans have lower rates of insurances coverage and less access to care Overview of Disparities Disparities are found across a range of clinical settings, including public and private hospitals, teaching and non-teaching hospitals, etc. Disparities in care are associated with higher mortality among minorities (e.g., Bach et al., 1999; Peterson et al., 1997; Bennett et al., 1995) Overview of Disparities Disparities consistently found across a wide range of disease areas and clinical services Disparities are found even when clinical factors, such as stage of disease presentation, co-morbidities, age, and severity of disease are taken into account Potential sources of healthcare disparities Health systems-level factors – financing, structure of care; cultural and linguistic barriers. Patient-level factors – including patient preferences, refusal of treatment, poor adherence, biological differences. Disparities arising from the clinical encounter. Causes of Death (2000) USA Mortality Rates* (All causes) 2000 Cardiovascular/Cerebrovascular Leading cause of death in African American men (33.5%) and women (40.6%) More than twice as likely to die from hypertensive heart disease Prevalence of high blood pressure one of the highest in the world ( worse in the southeastern US) 45% have blood cholesterol levels of 200 mg/dl 36%of African Americans have hypertension African Americans at greater risk than whites for death from both Two to three times greater risk to have an ischemic str