Study Tracks Ethnic Health Data

Latino adults in California are more likely to say that they are in poor health than Latinos in most other states, the Centers for Disease Control and Prevention reported Thursday.

The study, part of a growing effort to understand health disparities between minorities and whites, is the first to provide state-by-state comparisons.

Racial and ethnic disparities in health emerged as a major public health issue in the 1990s as research showed that African Americans, Latinos and some Asian Americans were faring worse than whites by many health measures.

The Atlanta-based center provided no explanation for the disparities in its report, but previous research has pointed to differences in income, education, diet and culture--not to race.

The study showed that whites also report significant differences in health from state to state. For example, 22% of whites in Kentucky rated their health as fair to poor, while only 3% of whites in the District of Columbia did so.

“This is a tool for states to use to see how they compare nationally,” said epidemiologist Julie Bolen, the study’s lead author. “On some indicators, such as colorectal cancer screening, every group is doing poorly. Fortunately, most of the issues we talk about in this report relate to behaviors that can be changed.”

The 60-page study tracked 16 health-related measures covering access to care, health status, risk behaviors and preventive screenings. Included were such factors as lack of health insurance, obesity, cigarette smoking and regular mammograms. The information was compiled from surveys taken by state health departments.

Bolen said that the study should be viewed as an initial effort and that much work remains to be done. For example, the results did not adjust for differences in age among populations in the various states, and that is a key variable in assessing health risks.

As a whole, Californians were more likely to be uninsured than residents of other states. Nineteen percent of all Californians lacked coverage, compared with a median of 12% for the nation. Among Latinos, the gap in coverage was even wider. In California, 39% of Latino adults were uninsured, compared with a median of 23% nationally.

Bill Wright, head of cancer surveillance for the state health department, said that the high proportion of uninsured might help explain why more Latinos in California report being in poor health. “We’re not doing too well on that particular health care indicator,” he said.

Twenty-six percent of Latino adults in California said that they were in fair to poor health, compared with a median of 16% among Latinos nationally. In Texas, about the same proportion of Latinos as in California reported fair to poor health, but in New York, Florida, New Mexico and Arizona, a smaller share of Latinos reported poor health.

Among African Americans and Asian Americans, Californians were less likely to say they were in fair to poor health.

For all racial and ethnic groups, California fared well in seat belt usage, a simple but important means of preventing serious injuries. For example, a median of 38% of African Americans nationally said that they do not always wear seat belts. But in California, only 18% of blacks said they do not buckle up all the time.

With the exception of African Americans, Californians were also less likely to be cigarette smokers. And with the exception of Latinos, Californians were less likely to be obese and more likely to exercise in their leisure time.

For Asian Americans, many states lacked a sufficiently large population to allow for comparisons. However, Asian Americans in California were more likely to have health insurance and less likely to say that they were in poor health than Asian Americans nationally.

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How California Compares

Selected health measures for whites and minorities.

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White Black Latino Asian Adults who say they’re in fair to poor health California 10% 18% 26% 8% National median 12% 19% 16% 9% * Adults who don’t exercise California 17% 22% 38% 25% National median 25% 38% 34% 29% * Adults who smoke California 19% 27% 17% 8% National median 24% 23% 23% 11%

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