Infant Mortality
Health Care Disparities in Infant Mortality
Numerous empirical studies have demonstrated a significant discrepancy in survival rates of newborns of different race. It has been shown that black infants are two times more likely to die within the first month of life than their white counterparts. Identification of these disparaged findings has prompted analysis of health care offered from a demographic perspective, considering racial treatment and socioeconomic conditions. The Center for Disease Control (CDC) has examined race-specific mortality information on newborns, and reported a series of noted and persistent trends coinciding with the data differences. It is necessary to address this inconsistency in survival rates between the black and white races to identify potential changes in health care delivery systems and eliminate racial factors in infant mortality.
The U.S. government has identified six classes of racial and ethnic minority discrepancies in health care access, experience, and outcomes. In addition to infant mortality issues, the areas also include cancer screening and management, cardiovascular disease, diabetes, HIV infection and AIDS, and immunizations. In 1998 the presidential goal was established committing governmental resources to eliminating these health care differences and improving the overall health of all Americans. This involved contributions by the Health and Human Services (HHS) department. The strategies for administering these goals were written up in the Healthy People 2010, a revision of Healthy People 2000, specifically addressing the greater degree of illness and death experienced by minorities. Through this agenda, targeted disparities were identified, reliable national data was accumulated, near-term goals outlined, and Department leadership and resources put forth to accomplishing improvements in the health care provided to affected groups.
The HHS has an outline of their plan to combat health care discrepancies (HHS, 2000). Their goals are directed at providing leadership through research, and expanding and improving programs aimed at the delivery of health care services, poverty reduction, safe and healthy environments, and trauma and disease prevention. The committee providing these tasks is headed by the Assistant Secretary for Planning and Evaluation of the Department and the Surgeon General. They partnership with state and local governments, and national and regional minority health organizations, to gain better access to affected communities. The charge of the HHS involves the directed review of disparity reduction goals and currently developed applicable programs. They also determine consultation programs for the minority communities, as well as the health services groups, and review scientific data, demographics, and health care services for their potential areas of improvement in order to satisfy the goal of eliminating racial and ethnic factors in the outlined six groups.
Specifically considering the research aspect of the HHS minority outreach programs, the Department has required changes to be made to local and national data collection formats. For instance, they have adopted a policy requiring all HHS-sponsored data reporting programs to itemize racial and ethnic categories. The goal of this addition to the data reports allows the HHS to better monitor the distribution of federal funds for the guarantee that monies, services, and health care access are being equally applied in a nondiscriminatory manner. Also, improved interactions, interventions, and partnerships can be provided to minority communities to stimulate research involvement for disparaged groups, and determine and implement better strategies for health care access and delivery.
The persistence of infant mortality rate disparities among black and white babies, as addressed by Healthy People 2010, also involves the intervention by the CDC. The CDC has analyzed data from birth and death certificates obtained from the National Center for Health Statistics (Iyasu et al., 2002). Through this examination certain trends in infant mortality rates related to low birth weight (LBW) at less than 2500 grams and very low birth weight (VLBW) at less than 1500 grams were identified for the years 1980 to 2000. A subcategory of data analysis included birth weight-specific mortality rates (BWSMRs), calculated from data collected for 1983 to 1991 and 1995 to 1999. Race-specific data for these three categories used the mother's race. Statistics showed that 3,612,258 live births occurred in 1980 (almost 3 million born to white women and over 560,000 to black women), with an average of 12.6 deaths per 1,000 live births. These statistics significantly improved for all races, with infant mortality decreasing 45.2% in the year 2000, with 6.9 deaths in 1,000 live births, and 4,064,948 total births reported (3.2 million to white women and almost 620,00...
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