Diversity Data Snapshots March 2014 Edition

Diversity Data Snapshots March 2014 Edition Diversity Policy and Programs

CDC Health Disparities and Inequalities Report United States, 2013 CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), 1-187

Health Insurance Coverage United States, 2008 and 2010 Ramal Moonesinghe, PhD 1 Man-huei Chang, MPH 2 Benedict I. Truman, MD 3 1 Office of Minority Health and Health Equity, Office of the Director, CDC 2 Center for Surveillance, Epidemiology, and Laboratory Services, CDC 3 National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC

Health Insurance Coverage United States, 2008 and 2010 In 2010 there was a higher percentage of uninsured males (24.1%) than females (18.8%). The uninsured rate for young adults aged 18 34 years (29.8%) was approximately double the uninsured rate for adults aged 45 64 years (15.4%) Among adults aged 18-64, 41.6% of Hispanic and 22.1% of non-hispanic Blacks were classified as uninsured. In 2010, Hispanics accounted 16% of the entire population and for 29.3% of the uninsured population. 50.7% of uninsured adults were near poor Uninsured rates for persons in the poor and near poor categories increased significantly in 2008 from 37.0% and 30.5%, respectively to 41.2% and 34.2%, in 2010. The uninsured rate for non-hispanic Blacks also increased significantly from 22.1% in 2008 to 26.2% in 2010. CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), pp.61-64.

Percentage of Adults aged 18-64 Years Without Insurance in 2010, by Poverty Status 100% 90% 80% 70% 60% 50% 40% 30% 41% 34% 20% 10% 8% 0% Poor Near Poor Non Poor CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), pp.61-64.

Percentage of Adults Aged 18-64 Years Without Insurance in 2010, by Educational Attainment 100% 90% 80% 70% 60% 50% 40% 43% 30% 20% 28% 20% 10% 8% 0% Less than High School High School Graduate or Equivalent Some College College Graduate or Higher CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), pp.61-64.

Percentage of Adults Aged 18-64 Years Without Insurance in 2010, by Race/Ethnicity 100% 90% 80% 70% 60% 50% 40% 41% 30% 26% 20% 10% 16% 17% 0% Hispanic White, non-hispanic Black, non-hispanic Asian/Pacific Islander CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), pp.61-64.

Colorectal Cancer Incidence and Screening United States, 2008 and 2010 C. Brooke Steele, DO Sun Hee Rim, MPH Djenaba A. Joseph, MD Jessica B. King, MPH Laura C. Seeff, MD National Center for Chronic Disease Prevention and Health Promotion, CDC

Colorectal Cancer Incidence and Screening United States, 2008 and 2010 In 2010, the percentage of persons up to date with colorectal cancer (CRC) screening differed by age bracket. 76.1 % of persons aged 65-75 reported being up to date with CRC screening compared with 59.7% of those aged 50-64. 66.4 % of non-hispanic Whites were up-to-date with CRC screening and 64.8% of non-hispanic Blacks, while only 54.4% of Asian/Pacific Islanders, 55.2% of American Indian/Alaskan Natives reported being up to date. 62.5% of Non-Hispanic Whites reported having had a colonoscopy within 10 years preceding the survey compared with 59.8% of Non-Hispanic Blacks, 49.3% of Asian/Pacific Islanders,48.9% of American Indians/Alaskan Natives and 45.4% of Hispanics. Non-Hispanic Blacks (15.1%) had the greatest proportion of respondents reporting having had Fetal Occult Blood Testing within the year preceding the survey. CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.53-60.

Reported rates of test use increased with increasing education level and household income, 39.2% of respondents with less than a high school education were screened for CRC compared to 72% of respondents with a college degree. 47.7% of respondents with an average annual income less than $15,000 reported being screened for CRC compared to 73.4% of respondents with an income of $75,000 or more. CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.53-60.

100% 90% Colorectal Cancer Screening Rates of Adults Aged 50-75 Years by Average Annual Income in 2010 80% 70% 65% 69% 73% 60% 56% 50% 48% 40% 30% 20% 10% 0% < $15,000 $15,000 - $34,999 $35,000 -$49,999 $50,000- $74,999 >75,000 CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.53-60.

100% 90% Colorectal Cancer Screening Rates Aged 50-75 Years, by Educational Attainment in 2010 80% 70% 66% 72% 60% 59% 50% 49% 40% 39% 30% 20% 10% 0% Less than High School Some High School High School Graduate or Equivalent Some College/Technical School College Graduate CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.53-60.

Prevalence of Hypertension and Controlled Hypertension United States, 2007 2010 Cathleen D. Gillespie, MS1 Kimberly A. Hurvitz, MHS2 1National Center for Chronic Disease Prevention and Health Promotion, CDC 2National Center for Health Statistics, CDC

Prevalence of Hypertension and Controlled Hypertension United States, 2007 2010 The highest rates of hypertension were observed among those aged 65 years (71.6%), adults with diabetes (59.4%), and non-hispanic Black adults (41.3%). Hypertension prevalence increased with age from 9.8% (18-44 years) to 71.6% ( 65) and decreased as income increased. Non-Hispanic Blacks had a higher rate of hypertension (41.3%) than non- Hispanic Whites (28.6%) and Hispanics (27.7%). Adults born in the United States had a higher rate of hypertension (30.6%) than non-u.s.-born adults (25.7%). Adults aged <65 years with public insurance had a higher rate of hypertension (28.3%) than those with private insurance (20.0%) and those with no insurance (20.4%). CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.144-148.

Prevalence of Hypertension and Controlled Hypertension United States, 2007 2010 Persons with diabetes had a significantly higher rate of hypertension than those without diabetes (59.4% versus 27.7%), Those who were obese had a higher rate of hypertension compared with those who were not (40.5% versus 25.0%) Persons with a disability had a significantly higher rate of hypertension compared with those with no disability (40.2% versus 29.0%). Differences in the prevalence of blood pressure control were observed among all population groups except veteran status. Non-Hispanic blacks (42.5%), Hispanics (34.4%), and Mexican Americans (30.3%) had lower prevalence of blood pressure control compared with non- Hispanic Whites (52.6%). Persons with disabilities (59.3%), veterans (52.5%), and females (55.5%) had higher rates of blood pressure control than their counterparts. CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.144-148.

Prevalence of Hypertension and Blood Pressure Control Among Adults > 18 Years, by Country of Birth (2007-2010) 100% 90% 80% 70% 60% 50% 40% 49% 39% United States Outside of the United States 30% 31% 26% 20% 10% 0% Hypertension Blood Pressure Control CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.144-148.

Prevalence of Hypertension and Blood Pressure Control Among Adults > 18 Years, by Health Insurance Status (2007-2010) 100% 90% 80% 70% 60% 60% 50% 40% 51% Private Public Uninsured 30% 28% 28% 20% 20% 20% 10% 0% Hypertension Blood Pressure Control CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.144-148.

Expected Years of Life Free of Chronic Condition Induced Activity Limitations United States, 1999 2008 Michael T. Molla, PhD National Center for Health Statistics, CDC

Expected Years of Life Free of Chronic Condition Induced Activity Limitations United States, 1999 2008 Total life expectancy at birth for males increased by 1.7 years, from 73.9 years in 1999 to 75.6 years in 2008 Female life expectancy at birth increased by 1.2 years, from 79.4 years in 1999 to 80.6 years in 2008. Expectation of life at birth for the White population increased by 1.2 years, from 77.3 years in 1999 to 78.5 years in 2008. Life expectancy for the Black population increased by 2.6 years, from 71.4 years in 1999 to 74.0 years in 2008. CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.87-92.

Life Expectancy at Birth by Sex from 1999-2008 82 80 80.6 79.4 78 76 75.6 Male Female 74 73.9 72 70 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.87-92.

Life Expectancy at Birth by Race from 1999-2008 80 78 77.3 78.5 76 Age in years 74 72 74 White Black 71.4 70 68 66 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.87-92.

Diabetes United States, 2006 and 2010 Gloria L. Beckles, MD Chiu-Fang Chou, DrPH Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion

Diabetes United States, 2006 and 2010 In 2006, for every 100 non-hispanic white woman diagnosed with diabetes, there were 200 non-hispanic Black women diagnosed. That disparity decreased in 2010, in that for every 100 non-hispanic white woman diagnosed, there were 177 non-hispanic Black women diagnosed. In 2006 and 2010, the groups with the lowest levels of education and income continued to experience the greatest disparity in age-standardized prevalence and incidence of diagnosed diabetes. The age-standardized prevalence of persons medically diagnosed with diabetes with less than a high school education, increased from 9.1% to 11.6% in 2010. The prevalence of among those with a college degree or higher was 5.8% in 2010. Diabetes prevalence among persons with disabilities was 12.1% in 2010 versus 4.9% for persons without a disability. CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.99-104.

Age-Standardized Prevalence of Medically Diagnosed Diabetes among Adults, by Race/Ethnicity, 2010 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 7% 11% 8% 14% 12% 0% White, non-hispanic Black, non-hispanic Asian Mixed race/ Other Hispanic CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.99-104.

Age-Standardized Prevalence of Medically Diagnosed Diabetes among Adults, by Disability Status, 2006 and 2010 100% 90% 80% 70% 60% 50% 40% With a Disablity Without a Disablity 30% 20% 10% 0% 11% 12% 4% 5% 2006 2010 CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.99-104.

Age-Standardized Prevalence of Medically Diagnosed Diabetes among Adults, by Educational Attainment, 2010 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 12% 9% 9% 6% 0% Less than High School High School or Equivalent Some College Degree College Degree or Higher CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.99-104.

Education and Income United States, 2009 and 2011 Gloria L. Beckles, MD 1 Benedict I. Truman, MD 2 1National Center for Chronic Disease Prevention and Health Promotion, CDC 2National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC

Education and Income United States, 2009 and 2011 Racial/ethnic, socioeconomic, and geographic disparities in non-completion of high school and poverty persist in the U.S. adult population Very little evidence of improvement from 2009 to 2011. In 2011, among adults aged 25 years and older, 33.7 % of all foreign born adults did not complete high school vs. 8.7% of U.S.-born adults In 2011, disparities in poverty increased with decreasing level of educational attainment. 16.6% of adults classified as poor based on the U.S. Census Bureau poverty thresholds did not complete high school compared with 10.3% of those in the high income group. In the 2011, the non-completion rate of high school among adults > 25 was the highest among Hispanics (37.7%) compared with 11.3% of those belonging to multiple races, 18.8% of American Indians/Alaskan Natives, 12.1% of Asian/Pacific Islanders, 16.1% of non-hispanic Blacks, and 7.3% of non-hispanic whites. CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.9-19.

High School Non-completion Rates of Adults aged > 25 years by Race, 2009 and 2011 100% 90% 80% 70% 60% 50% 40% 30% 40% 38% 2009 2011 20% 10% 8% 7% 17% 16% 13% 12% 20% 19% 13% 11% 0% White, non Hispanic Black, non Hispanic Asian/Pacific Islander American Indian/Alaskan Native Multiple Races Hispanic CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.9-19.

Health-Related Quality of Life United States, 2006 and 2010 Matthew M. Zack, MD Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC

Health-Related Quality of Life United States, 2006 and 2010 In 2010,16.8% of women reported fair or poor health compared with 15.4% of men. In 2010, a significantly lower percentage of non- Hispanic Whites (13.3%) rated their health as fair or poor than did all other racial/ethnic groups (Black, non-hispanic 23.3%, Hispanic 28.1%, American Indian/Alaskan Native 30.8%) except Asian/Pacific Islanders (11.9%). Non-Hispanic Blacks reporting fair or poor health increased from 21.3% in 2006 to 23.3% in 2008. While Hispanics reporting fair or poor health decreased from 31.1% to 28.1%. In 2010 38.4% of those with less than a high school education reported fair or poor health, compared with 7.3% of college graduates. In 2010, 39.4% of persons with a disability reported fair or poor health compared with 8.6% of persons without a disability. CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.105-111.

Estimated Percentage of Adults >18 Years Reporting Fair or Poor Health, by Educational Attainment (2010) 100% 90% 80% 70% 60% 50% 40% 38% 30% 20% 20% 16% 10% 7% 0% Less than High School High School Graduate or Equivalent Some College/Technical School College Graduate CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.105-111.

Estimated Percentage of Adults >18 Years Reporting Fair or Poor Health, by Disability Status (2006 and 2010) 100% 90% 80% 70% With Disability Without Disability 60% 50% 40% 39% 39% 30% 20% 10% 9% 9% 0% 2006 2010 CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.105-110.

Obesity United States, 1999 2010 Ashleigh L. May, PhD David Freedman, PhD Bettylou Sherry, PhD Heidi M. Blanck, PhD Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC

Obesity United States, 1999 2010 Between 1999 2002 and 2007 2010, the age-adjusted prevalence of obesity among adults aged 18 years increased from 26.5% to 33.0% among men and from 32.4% to 34.9% among women. Among men, there was little difference in the prevalence of obesity by race/ethnicity Among women, the overall (1999 2010) prevalence among non-hispanic Blacks (51%) was 10 percentage points higher than that among Mexican- Americans (41%) and 20 percentage points higher than non-hispanic White women (31%). For men, the prevalence was lowest (25%) among college graduates but highest (35%) among those who had completed some college. Among women, the overall prevalence of obesity among those who had completed college (24%), was 13 16 percentage points lower than in other groups. CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.120-128.

Obesity among Adults 23 years, by Sex, Race/Ethnicity, and Educational Attainment (1999-2010) CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.120-128.

Access to Healthier Food Retailers United States, 2011 Kirsten A. Grimm, MPH Latetia V. Moore, PhD Kelley S. Scanlon, PhD National Center for Chronic Disease Prevention and Health Promotion, CDC

Access to Healthier Food Retailers United States, 2011 51.5% of persons in rural census tracts lacked access to a healthier food retailer compared with 20.6% of persons residing in urban tracts. Census tracts where seniors comprised more than 13.6% of the population were 1.3 times as likely not to have a healthier food retailer than tracts with a lower proportion of seniors, a pattern that was similar across regions. Nationwide, persons in tracts with an average annual income of less than 27,269 dollars were approximately 1.2 times as likely to lack access to a healthier food retailer than people in tracts with higher income. In census tracts where < 27% of the population had a college education, people were significantly more likely to lack access to healthier food retailers (33.3%) than were individuals in a tract with a higher percentage of college educated persons (25.8%). CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), pp.20-26.

Percentage of Census tracts without at least one healthier food retailer within the tract or within ½ mile of the tract 100% 90% 80% 70% 60% 50% 40% 30% 27% 37% 32% 24% 20% 10% 0% Northeast Midwest South West CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.20-26.

Urban versus Rural Differences in Lack of Access to Healthy Food Retailers, by Region. 100% 90% 80% 70% 60% 50% 52% 53% 51% 50% Rural 40% Urban 30% 27% 20% 20% 20% 16% 10% 0% Northeast Midwest South West CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.20-26.

HIV Infection United States, 2008 and 2010 Anna Satcher Johnson, MPH Linda Beer, PhD Catlainn Sionean, PhD Xiaohong Hu, MS Carolyn Furlow-Parmley, PhD Binh Le, MD Jacek Skarbinski, MD H. Irene Hall, PhD Hazel D. Dean, ScD National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC

HIV Infection United States, 2008 and 2010 During 2010, the rate of Blacks/African Americans were diagnosed with HIV infections at the rate of 84 per 100,000, compared with 13.5 per 100,000 of American Indians/Alaskan Natives, 8.4 per 100,000 of Asians, 30.9 per 100,000 of Hispanics, 27.0 per 100,000 of Native Hawaiians/Pacific Islanders, and 9.1 per 100,000 of whites. The rate of HIV infection diagnoses for Black/African American males in 2010 was 128.4 per 100,000 population compared with 16.5 White males per 100,000. The rate of HIV infection diagnoses for Black/African American females in 2010 was 45.3 per 100,00 population compared with 2.2 White females per 100,000. Persons 55 years of age and above had the lowest HIV infection diagnosis rate of 5.8 per 100,000, compared with 32.3 per 100,000 of persons in the 25-39 year old age group. CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.112-119.

Estimated Rate* of HIV Infection Diagnoses among Adults 18 years, by Sex and Race/Ethnicity, 2010 140 128 Male Female 120 Rate per 100,000 population 100 80 60 40 20 20 0 American Indian/ Alaskan Native *Per 100,000 population 7 15 3 Asian 45 Black/African American 50 49 10 Hispanic/Latino 5 Native Hawaiian/Other Pacific Islander 16 2 White 47 11 Multiple Races CDC Health Disparities and Inequalities Report United States, 2013. (2013). Morbidity and Mortality Weekly Report (MMWR) Supplements, 62(Supplement No. 3), p.112-119.

Health Disparities Contact Information For more information regarding health disparities, please contact Karey Sutton: Karey Sutton, Ph.D. Lead Specialist Health Equity Research and Policy Scientific Affairs Association of American Medical Colleges ksutton@aamc.org 44

DDS Contact Information For more information regarding the Diversity Data Slides (DDS), please contact: Sarah Conrad, M.S. Senior Research Analyst Diversity Policy and Programs Association of American Medical Colleges Ph: 202-828-0560 sconrad@aamc.org 45