Chapter 10
Racial & Ethnic Populations
Chapter 10
2010 US Census Data
Overview of Diversity Trends
Projected U.S Population by 2050
© U.S Census Bureau
2019 New York City Population
32% White
22% Black
29% Hispanic
14% Asian
37% of residents are foreign born
17% of residents are non citizens
800 languages are spoken in NYC
Problems with Diversity Statistics
Self-reported data is never 100% reliable
People of mixed races/ethnicities have trouble knowing where they fit on forms
Many health information systems/forms do not consistently collect race/ethnicity data
Some people choose NOT to report race/ethnic data. Why?
Why is it crucial to report census data accurately?
Americans of Hispanic Origins
*Largest minority group in US; not fastest growing
*Lowest education levels; Why?
*Lower incomes and higher poverty rates than whites
*More work-related health issues. Why?
*The majority of Hispanics in the US come from what country?
US—Mexican Borde
Hispanics in US:
35 million are from Mexico
5 million from Puerto Rico
2 million from Cuba
1.8 million from Dominican
Republic
Black Americans
Black Americans/African Americans
2nd largest minority group in America
More than ½ live in what part of the US?
Lower education levels than whites, but higher than Hispanics
Lowest incomes/highest poverty rates (about 1 in 4)
Long-term effects of slavery, oppression, discrimination may still be having an impact on health
*
Life Expectancy by Race
Which race has the longest life expectancy?
Which race has the shortest life expectancy?
Refugees and Immigrants
Refugees: People who flee their home country to seek protection from danger in another country; may be granted asylum for humanitarian reasons
Immigrants: People who come from other countries to set up residence and seek a better future; make up about 14% of US population (legal and undocumented)
Legal immigrants: granted permission to live and work in the US for a specific period of time
Unauthorized (undocumented) immigrants: living and working in the US without permission
*
Immigrant Populations in the US 2018: 44 million
Secretary’s Task Force on Black and Minority Health 1985
Identified health disparities: differences in mo
idity & mortality rates that exist among specific population groups
Over 80% of excess mortality in minorities was due to 6 health problems, including:
Infant mortality
Cancer
Heart disease and stroke
Diabetes
death rates 2 ½ times higher in Blacks and Native Americans than Whites
hospital admissions for long-term care of diabetes is highest in Blacks and Hispanics
Prostate Cancer and Race
Which group has the highest rates of prostate cancer?
*
Hypertension and Race
Having hypertension puts you at risk for what other major health problems?
Which race has the highest rate of hypertension and tends to develop it earlier in life?
*
HIV/AIDS
1985
2018
CDC New Diagnosis of HIV 2018
Health Disparity:
All minorities together make up about 37% of the US population,
ut account for almost 74% of new cases of HIV.
Blacks alone make up 44% of new cases, while they are only 12% of the total US population.
Why is HIV risk highest in
Blacks? (CDC)
1 in 7 Blacks with HIV is unaware of their infection (more likely to pass it to others).
More existing co-conditions. What does this mean?
Stigma, fear, discrimination, and homophobia may prevent Blacks from accessing HIV prevention and care services.
More poverty & less access to healthcare that could provide early diagnosis and treatment
Social Determinants of Health
Socio-Economic Status (SES) is defined as: “a group’s living circumstances” (made up of education level, employment status, income, housing status, access to healthcare)
This is considered to be the main reason for health disparities
Those with low SES consistently have poorer health, regardless of race or ethnicity
Racial disparities in health are rarely caused by biological differences
Culturally and Linguistically Appropriate Services (CLAS) in Healthcare
Recruiting more minorities into healthcare professions
There are about 700,000 practicing physicians in the US; what % are Black or Hispanic?
Training and educating healthcare workforce in culturally and linguistically appropriate policies and practices
Partner with community to design/implement/evaluate policies, practices, services
Solutions: Creating Cultural Competency in Healthcare
Offer language assistance to individuals with limited English proficiency at no cost to facilitate access to healthcare services
Provide easy to understand print and multimedia materials/signage in languages commonly used by community members
Collect/maintain accurate data to assess the impact of CLAS on health equity
Chapter 10 Racial and Ethnic Populations Lecture Notes
Slide 1—Title slide: For the past several weeks we looked at different types of community groups based on age to learn more about some of the health issues they face. This week we turn our attention to a different type of community group based on race and ethnicity.
Slide 2—Our information on the racial/ethnic composition of the country comes from the US Census data, which is collected every 10 years. The last census was taken in 2010—and the results are reported on the graph (pie chart) on this slide. The 2020 Census has just recently concluded and, over the next year as the results are reported, we will likely see changes from the 2010 data. The 2020 Census was conducted in the middle of the pandemic, so we have concerns about how accurate it will be.
Here are the main points:
In 2010, there were about 308 million people in the US.
64% of the population was White; 16% Hispanic; 12% Black; 5% Asian.
Slide 3—This slide shows trends within different populations. You can see that the trend for whites is downward. In the year 2000, 69% of the US population was white and it has been decreasing ever since then. This shows that by 2050, the white population will be down to about 50%.
You can see that the trend for Hispanics is upward with their percentages expected to almost double from 2000 – XXXXXXXXXXfrom 12.6 % to 24.4% projected for 2050).
The trend for Blacks is upward, too, though at a much smaller level of increase. (12.7% in 2000 to a projected 14.6 in 2050).
Finally, if we look at the Asian population—they are cu
ently the fastest growing minority group in the US. They increased from 3.8% in 2000 to a projected 8% in XXXXXXXXXXThat means their % of the population will more than double by 2050.
Summary: The only group projected to decrease is the White population; all others are projected to increase, though at different rates. What that means is we are becoming more diverse as a nation with each passing year.
Slide 4—NYC is not like the rest of the country—we are much more diverse. (Most cities are more diverse than subu
an and rural areas.) You can compare our numbers to those on the previous slide. NYC is much less white than the nation as a whole. The % of Hispanics and Blacks in NYC exceeds the national rate. The Asian population is almost 3x higher than the national rate.
Slide 5—How accurate are these numbers? We really don’t know, but many experts believe the numbers reported for racial/ethnic populations are most likely too low. Some of the reasons are on this slide.
Most of the time, this information is self-reported on forms. That can mean each person has the ability to self-identify while that might not be biologically or genetically accurate. Here’s an example: Barack Obama often said that he self-identified as Black or African-American. We refer to him as the first Black president. But he is actually mixed-race, since his father was Kenyan (African) and his mother was White. How you see yourself is generally going to affect how you fill out any self-reported form.
Also—many forms have limited choices. So, if we are mixed-race, we might not see an appropriate option on the form and end up checking the box that seems closest to how we see ourselves, even if that is not completely accurate.
As for the data on health, it’s only been in recent years that we’ve made a more serious attempt to include accurate reporting of race/ethnicity on health-related forms. We have traditionally had much better tracking of health data on age and sex than on race/ethnicity.
Some people choose NOT to report this information because they may wo
y about discrimination and racism. If you feel this factor may work against you if someone picks up the form and sees your race/ethnicity, then you may choose to leave this information blank on the form. For many people of color in the US, there is an understandable lack of trust that you will be treated equally based on your race.
As I stated earlier, the Census tells us how many people are living in the US and it provides information about race and ethnicity. But there are even more important reasons to make sure you fill it out every 10 years:
Census results help determine how billions of dollars in federal funding flow into states and communities each year. It affects how much money your community gets from the federal government for education, for healthcare, Medicaid, Medicare, job-training programs, transportation, etc. It also determines how many seats in Congress each state gets. If your community is undercounted in the Census because people living there did not fill out their forms, you will end up with less representation in Washington, and less political power.
Slide 6—A few facts from your text on the Hispanic population:
This is the largest minority group in the US—but it is no longer the fastest growing (Asians are now the fastest growing).
Hispanics tend to have lower rates of education which is most likely because of the language ba
ier. Some Hispanics, even if born and raised in the US, tend to speak Spanish at home and with friends. They might find it challenging to complete school when the instruction is solely in English. (Though later in life, when applying for jobs, being bilingual can be huge asset.)
Compared to whites, Hispanics have lower incomes and more poverty.
Hispanics tend to have more work-related injuries and work-related health issues. Lower education levels mean many find employment in jobs that require more physical labor: construction, restaurant kitchens, farm work, factories where injuries are more common.
The majority of Hispanics in the US overall are from Mexico—see next slide.
Slide 7—The US border with Mexico is almost 2000 miles long. Traditionally the states in the US that share a border with Mexico (Texas, New Mexico, Arizona, California) have high numbers of Hispanics from Mexico. (You can see Trump’s “wall” in the photos.)
Slide 8—A few facts from your text on the Black/African-American population:
Before the year 2000, this was the largest minority population in the US; it is now the 2nd largest. (Hispanics are #1.)
More than half of all Blacks live in Southern states. This has a lot to do with the history of slavery in the US. Blacks were
ought to the US involuntarily and forced to work on