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Cited by 222Health disparities and outcomesHealth and Medical StudiesPublic Health and Social Inequalities

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Surveillance of health status in minority communities - Racial and Ethnic Approaches to Community Health Across the U.S. (REACH U.S.) Risk Factor Survey, United States, 2009.

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Liao, Youlian, Bang, David, Cosgrove, Shannon, Dulin, Rick, Harris, Zachery, Taylor, April, White, Shannon, Yatabe, Graydon, Liburd, Leandris, Giles, Wayne·2011·Digital Repository at the University of Maryland
DOI 10.13016/0ydt-rppb
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Abstract

PROBLEM: Substantial racial/ethnic health disparities exist in the United States. Although the populations of racial and ethnic minorities are growing at a rapid pace, large-scale community-based surveys and surveillance systems designed to monitor the health status of minority populations are limited. CDC conducts the Racial and Ethnic Approaches to Community Health across the U.S. (REACH U.S.) Risk Factor Survey annually in minority communities. The survey focuses on black, Hispanic, Asian (including Native Hawaiian and Other Pacific Islander), and American Indian (AI) populations. REPORTING PERIOD COVERED: 2009. DESCRIPTION OF SYSTEM: An address-based sampling design was used in the survey in 28 communities located in 17 states (Arizona, California, Georgia, Hawaii, Illinois, Massachusetts, Michigan, New Mexico, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Virginia, West Virginia, and Washington). Self-reported data were collected through telephone, questionnaire mailing, and in-person interviews from an average of 900 residents aged ≥ 18 years in each community. Data from the community were compared with data derived from the Behavioral Risk Factor Surveillance System (BRFSS) for the metropolitan and micropolitan statistical area (MMSA), county, or state in which the community was located and also compared with national estimates. RESULTS: Reported education level and household income were markedly lower in black, Hispanic, and AI communities than that among the general population living in the comparison MMSA, county, or state. More residents in these minority populations did not have health-care coverage and did not see a doctor because of the cost. Substantial variations were identified in self-perceived health status and prevalence of selected chronic conditions among minority populations and among communities within the same racial/ethnic population. In 2009, the median percentage of men who reported fair or poor health was 15.8% (range: 8.3%-29.3%) among A/PI communities and 26.3% (range: 22.3%-30.8%) among AI communities. The median percentage of women who reported fair or poor health was 20.1% (range: 13.3%-37.2%) among A/PI communities, whereas it was 31.3% (range: 19.4%-44.2%) among Hispanic communities. AI and black communities had a high prevalence of self-reported hypertension, cardiovascular disease, and diabetes. For most communities, prevalence was much higher than that in the corresponding MMSA, county, or state in which the community was located. The median percentages of persons who knew the signs and symptoms of a heart attack and stroke were consistently lower in all four minority communities than the national median. Variations were identified among racial/ethnic populations in the use of preventive services. Hispanics had the lowest percentages of persons who had their cholesterol checked, of those with high blood pressure who were taking antihypertensive medication, and of those with diabetes who had a glycosylated hemoglobin (HbA1C) test in the past year. AIs had the lowest mammography screening rate within 2 years among women aged ≥40 years (median: 72.7%; range: 69.4%-76.2%). A/PIs had the lowest Pap smear screening rate within 3 years (median: 74.4%; range: 60.3%-80.8%). The median influenza vaccination rates in adults aged ≥65 years were much lower among black (57.3%) and Hispanic communities (63.3%) than the national median (70.1%) among the 50 states and DC. Pneumococcal vaccination rates also were lower in black (60.5%), Hispanic (58.5%), and A/PI (59.7%) communities than the national median (68.5%). INTERPRETATIONS: Data from the REACH U.S. Risk Factor Survey demonstrate that residents in most of the minority communities continue to have lower socioeconomic status, greater barriers to health-care access, and greater risks for and burden of disease compared with the general populations living in the same MMSA, county, or state. Substantial variations in prevalence of risk factors, chronic conditions, and use of preventive services among different minority populations and different communities within the same racial/ethnic population provide opportunities for public health intervention. These variations also indicate that different priorities are needed to eliminate health disparities for different communities. PUBLIC HEALTH ACTION: These community-level survey data are being used by CDC and community coalitions to implement, monitor, and evaluate intervention programs in each community. Continuous surveillance of health status in minority communities is necessary so that community-specific, culturally sensitive strategies that include system, environmental, and individual-level changes can be tailored to these communities.

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  1. Racial and Ethnic Approaches to Community Health Across the U.S. (REACH U.S.) Risk Factor Survey Participating Communities and Organizations CDC, National Center for Chronic Disease Prevention and Health Promotion, Division of Adult and Community Health: David Bang, PhD, Joyce Buckner-Brown, PhD, Shannon Cosgrove, MHA, Rick Dulin, BS, Wayne Giles, MD, Zachery Harris, BS, Youlian Liao, MD, Leandris Liburd, PhD, Thijuanie Lockhart, BBA, Aisha Penson, MEd, Mark Rivera, PhD, Paul Siegel, MD, Sakeena Smith, MPH, Alexandria Stewart, April Taylor, MPH, Pattie Tucker, DrPH, Shannon White, MPH, Graydon Yatabe, MPH. National Opinion Research Center at the University of Chicago: Ashley Amaya, MS, Martin Barron, PhD, Keeshawna Brooks, MA, Michael Bush, Kari Carris, PhD, Angela DeBello, MA, Katie Dekker, MA, Ned English, MS, Julie Gasparac, Carmelita Grady, PhD, Sheri Hamilton, Kate Hobson, MA, Adish Jain, MS, Michele Koppelman, MA, MBA, Peter Kwok, MS, Heather Leaver-Spear, Jeffrey Leintz, Moazzam Lokhandwala, Lauren McNamara, Corey Miller, Hiroaki Minato, MA, Robert Montgomery, MA, Whitney Murphy, MS, Edward Sipulski, Colm O'Muircheartaigh, PhD, Debra Oliver, Diane Preciado, Hee-Choon Shin, PhD, Kelly Van Hao, Kirk Wolter, PhD, Kanru Xia, MA, field and telephone interviewing staff. Richmond, Virginia: Vernon J. Harris East End Community Health Center: Lawrence Cary, Tracy Causey, MSPH, Ashlee Miller, Candace Nelms, Karen Wilson, MSW, Denise Wise, James Woody, BS; East End Partnership with Families-EEPF, Healthy Hearts Plus ll, Inc. West Philadelphia, Pennsylvania: To Our Children's Future with Health, Inc: Charmaine Sudler Milligan, Erica J. Purkett, MSW, Robin Foster-Drain, MD, Marsha Zibalese-Crawford, DSW; Haddington Community Health Project Collaborative. Kanawha and McDowell Counties, West Virginia: West Virginia Department of Health and Human Resources: Charlene Hickman, Regina Mitchell, Amber Stohr. Boston, Massachusetts: Center for Community Health, Education, and Research, Inc., Haitian-American Public Health Initiatives, Haitian Multiservice Service, Massachusetts Community Health Services, Cambridge Health Alliance, Boston Medical Center, Caribbean U-Turn, Greater Boston Nazarene Compassionate Center.
  2. Charleston and Georgetown Counties, South Carolina: Medical University of South Carolina, Charleston Diabetes Coalition, Georgetown Diabetes CORE Group, Alpha Kappa Alpha Sorority, Carolinas and Georgia Chapter of American Society of Hypertension, Diabetes Initiative of South Carolina, East Cooper Community Outreach, Franklin C. Fetter Family Health Center, Greater St. Peters Church of Our Lord Jesus Christ, Inc. (Palmetto Diocese), MUSC College of Nursing, SC DHEC Diabetes Prevention and Control Program (DPCP) and Epidemiology, SC DHEC Region 7, St. James-Santee Family Health Center, Tri-County Black Nurses Association, Trident United Way, Trident Urban League, Healthy Lifestyles Network, Palmetto Project.
  3. Grant and Hidalgo Counties, New Mexico: Hidalgo Medical Services, Grant County Community Health Council, Hidalgo Health Consortium, New Mexico Department of Health, the University of New Mexico, the New Mexico State University Cooperative Extension Offices, the Volunteer Center of Grant County, LULAC Grant County Chapter, The Wellness Coalition, Gila Regional Medical Center, SWORD (Southwest Outreach for Diabetes), FAN-C (Fitness and Nutrition in the Community group), Knights of Columbus, various community members.

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Metadata

Authors
Liao, Y., Bang, D., Cosgrove, S., Dulin, R., Harris, Z., Taylor, A., White, S., Yatabe, G., Liburd, L., & Giles, W.
Affiliations
Centers for Disease Control and Prevention (US)
ORCID
Liburd, Leandris
Venue
Digital Repository at the University of Maryland
Publisher
Digital Repository at the University of Maryland
Published
2011
Volume
60
Issue
6
Pages
1-44
DOI
10.13016/0ydt-rppb
OpenAlex
W1584187172
Cited by
222
References
6
Citations by year
2025: 4 · 2024: 9 · 2023: 7 · 2022: 12 · 2021: 7 · 2020: 13 · 2019: 21 · 2018: 17 · 2017: 10 · 2016: 24 · 2015: 26 · 2014: 17 · 2013: 22 · 2012: 26
FWCI
23.11
Type
journal article
Language
en
Open access
Licence
public-domain
Locations
  • PubMed (publishedVersion)
  • University Libraries (University of Maryland) (submittedVersion, public-domain)
  • Digital Repository at the University of Maryland (University of Maryland College Park)
  • PubMed
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health and Medical Studies
  • Social Sciences › Health › Public Health and Social Inequalities
Keywords
racial and ethnic health disparities, minority groups, health perception, chronic disease, hypertension, cardiovascular disease, diabetes mellitus, diabetes complications, health care access, health care coverage, household income, educational attainment, behavioral risk factors, alcohol consumption, substance use, physical activity, American Indian populations
MeSH terms
Adult, Aged, Asian, Black or African American, Chronic Disease, Data Collection, Educational Status, Female, Health Services Accessibility, Hispanic or Latino, Humans, Income, Indians, North American, Health Knowledge, Attitudes, Practice, Male, Middle Aged, United States, Insurance Coverage, Black People, Health Status Disparities, Healthcare Disparities

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