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"Our goal is to eliminate disparities in health among all population
groups by 2010," Secretary Thompson said. "While we are making progress,
this report shows how far we still have to go."
CDC Telebriefing Transcript
Health Improves for Most Racial, Ethnic Groups But Disparities Remain in
Some Areas
January 24, 2002
CDC MODERATOR: Good afternoon, and thank you for joining the CDC
Teleconference.
CDC is planning to hold a teleconference every Thursday at noon, so
hopefully you can count on those. There may be some exceptions during the
year when we don't hold one, but we will notify you either way with a media
advisory.
Today, CDC is releasing two new reports which present trends in racial and
ethnic disparities and key measures of health.
First, Dr. Ken Keppel and Jeffrey Pearcy of CDC's National Center for Health
Statistics will summarize the results of an analysis of the trends during
the 1990s in the 17 health status indicators established under Healthy
People 2000. These indicators take a broad view of health and include not
only the major causes of death, such as heart disease, cancer and stroke,
but also encompass cases of infectious disease, low birth weight, prenatal
care and other key health measures.
Second, Dr. Phyllis Wingo of CDC's Cancer Prevention and Control Program
addresses an article today's MMWR, taking a more in-depth look at trends and
differences by race, ethnicity, and sex for four cancer sites. Those are
lung, colon and rectum, prostate and female breasts, which together account
for more than half of cancer deaths each year.
We'll start with opening remarks from our speakers and then take questions.
Dr. Keppel?
DR. KEPPEL: Thank you.
One of the goals of Healthy People 2000, a decade-long national effort to
improve health and prevent disease was the reduction of disparities and
health by race, origin, and other characteristics.
Healthy People established hundreds of specific objectives, but identified
17 health status indicators that could be tracked at the national, state and
local levels for comparison purposes. This report tracks the success on
those key indicators over the past decade and measures the progress in
reducing disparities.
The study examines data for white non-Hispanic, black non-Hispanic, American
Indian or Alaskan Natives, Asian or Pacific Islander, and Hispanic groups.
The report shows significant improvements in the health of ethnic and racial
minorities, but also shows that substantial disparities persist among these
groups.
First, we found that between 1990 and 1998 all but one of the 17 indicators
improved for the U.S. as a whole. The percent of low-birth-weight infants
did not improve.
Second, we found that all five race and origin groups improved on 10 of the
indicators, including death rates for heart disease, motor vehicle crashes,
work-related injuries, TB, syphilis, infant mortality rates, prenatal care,
birth rates for teens, and air quality and also the homicide rate.
There was improvement on five additional indicators for every group except
native Americans. Native Americans failed to improve for all causes of death
combined, for stroke death rates, lung cancer death rates, and female breast
cancer death rates and suicide.
And then there was the percent of low-birth-weight infants for which there
was only one group that improved at all, and that was black non-Hispanics,
and the other four groups moved in the wrong direction.
Third, we developed an index of disparity to measure differences among all
five racial and ethnic groups. We did this so that we could determine
whether the differences among groups were changing over time. Based on this
index, the differences among groups declined for 12 of the 17 indicators
between 1990 and '98. That's good. It's good that the differences declined,
but the differences declined by 19 percent for only one indicator and by
about 10 percent for five other indicators.
In light of these modest reductions in disparity during the last 8 or 10
years, a great deal more effort will be required to eliminate disparities.
The differences among groups increased for five indicators, with substantial
increases for motor vehicle crash deaths, suicide death rates, and
work-related injury death rates.
Clearly, targeted efforts will be required to achieve the goal of
eliminating disparities between now and the Year 2010.
Thank you.
CDC MODERATOR: Okay. Now we will hear opening remarks from Dr. Phyllis Wingo.
DR. WINGO: Good afternoon.
The report from the Cancer Division at CDC provides information about trends
in cancer mortality during the same time period as the NCHS report and, as
Lisa already mentioned, for the top four cancers: lung and bronchus,
colon-rectum, prostate and female breast.
We examined the trends for each of these cancers over this time period by
sex and by the same racial and ethnic populations as used in the NCHS
report. I would like to highlight several key findings in the report, and
those are other death rates from the major cancers were generally decreasing
for blacks in the 1990s. Blacks continued to have the highest of all racial
and ethnic group--highest cancer mortality rates of all of the racial and
ethnic groups that we studied.
Second, in the 1990s, the death rates for the top four cancers were
generally increasing for American Indians and Alaskan Natives.
Third, lung cancer death rates during this time period were increasing among
black and white women, on average, of about 1 percent year and among
American Indian and Alaskan Native women at an even greater rate--on
average, 2 to 3 percent per year.
Finally, throughout the 1990s, breast cancer death rates decreased for white
women on average 2.5 percent per year, and for Hispanic women, on average,
1.1 percent year. Breast cancer death rates were relatively unchanged for
black, American Indian, Alaskan Native and Asian and Pacific Islander women.
So, for three of the four cancers studied, we can point to prevention. The
declines in death rates for cancers of the lung and bronchus, colon-rectum,
and female breasts are due, in part, to decreases in tobacco smoking, early
detection and more effective treatment.
Although death rates from prostate cancer are also decreasing, the reasons
for this are less clear and point toward a need for more research to better
understand the reasons for these declines.
Success in reducing cancer death rates has not been shared equally by all
racial and ethnic groups, and has not been shared equally between men and
women. Differences in cancer death rates that cross the racial and ethnic
populations, probably result from a combination of factors, including
health, behavior such as smoking, exercise and nutrition, access to
preventive screenings, diagnostic and therapeutic services, and the
aggressiveness of the treatment prescribed.
If these factors were modified, more than half of cancer deaths could be
prevented, and most racial and ethnic disparities in cancer death rates
could be eliminated.
Thank you very much.
CDC MODERATOR: Okay. Now we will take questions, and I just ask that you
state who you are directing your question to. First question, please.
AT&T MODERATOR: And once again, ladies and gentlemen, if you do have a
question, please press the 1 at this time. And we have a question from the
line of Kim Dixon with [inaudible] News. Please go ahead.
QUESTION: Hi. I just wanted to clarify the rate increase of lung cancer
among women. You said it's 1 percent, about 1 percent per year. Is that
right?
DR. WINGO: Yes, that 1.1 percent per year. Between 1990 and 1998.
QUESTION: So could I say it's 10 percent over the 8-year period because it
is a jump of 3 percentage points out of 31.6? Is that accurate?
DR. WINGO: Mathematically that usually doesn't quite work out that way.
QUESTION: Okay.
DR. WINGO: I would stick to the 1--on average 1.1 percent per year.
QUESTION: Per year, okay. Okay, great. Thanks.
DR. WINGO: You're welcome.
AT&T MODERATOR: And we have a question from the line of Emma Hitts with
Reuters Health. Please go ahead.
QUESTION: Yes. Hi. This is directed to Dr. Wingo or Keppel. I was wondering,
was there any one health society that seemed to have the greatest effect on
the differences in rates, you know, such as screening or other preventive
methods, and what plans does the CDC have to eliminate these disparities at
this time?
CDC MODERATOR: Do you want to start, Dr. Keppel?
DR. KEPPEL: Well, perhaps the biggest success during this period was in
syphilis, that case rate. Black non-Hispanics had a rate of 41.9 per 100,000
in 1990, and this was reduced by 88 percent between 1990 and '98. So there
is a very, very substantial reduction in rates of syphilis for black
non-Hispanics, and also for the other groups. So that nationally Healthy
People 2000 target for syphilis were reached for both the total population
and for the black population.
CDC MODERATOR: And, Emma, CDC does have a National Syphilis Elimination
program that started several years ago, and we'd be happy to give you more
information about that if you wanted to call after the conference call.
QUESTION: Okay, thanks.
CDC MODERATOR: Next question?
AT&T MODERATOR: And that's from the line of Aaron McClaren with the
Associated Press. Please go ahead.
QUESTION: Hi, thanks. This question is for either of you. I'm wondering
about some of the specific things we could to eliminate the disparities in
some of these other diseases, some of these other factors. Some of the gaps
are pretty glaring, and it seems to me a pretty lofty goal to eliminate
these disparities by 2010. What are some of the specific things we can do
beyond syphilis?
CDC MODERATOR: Want to start, Dr. Keppel?
DR. KEPPEL: Well, we've got a tremendous range of factors that are
associated with these differences. Certainly some of the differences are due
to social and economic factors. Others are due to behavioral factors. I
can't point to specific--in most of these instances I can't point to
specific programs that would address some of these differences. However,
there certainly are substantial plans associated with Healthy People 2000,
strategic plans within CDC and within NIH and so forth, that are targeted to
the reduction of specific disparities. So we could refer you to some other
sources on this I think.
CDC MODERATOR: Yeah. Aaron, we do have the Reach program here at CDC that's
been in the works for about two years now, and I'd be happy to hook you up
with somebody to talk about that, what's going on in the field.
QUESTION: Thank you.
CDC MODERATOR: Did you want to add anything, Dr. Wingo?
DR. WINGO: Sure. And of course my comments are strictly about cancer as
opposed to the 17 indicators that Dr. Keppel has been commenting on.
I think from a cancer perspective the health disparities that should be
addressed, we should think about the health behaviors such as tobacco use,
overweight and obesity, physical activity. I think they're also--these are
all leading health indicators for Healthy People 2010.
I also think that from a cancer perspective, we have to talk about equal
access to care for all populations, equal access to preventive services to
effective screening and diagnostic tools and effective treatments as well.
CDC MODERATOR: Okay. Next question.
AT&T MODERATOR: And once again, ladies and gentlemen, if you do have a
question, please press the 1 at this time.
And Ms. Swenarski, there are no further questions on queue.
CDC MODERATOR: Okay. Would either of the spokespeople like to add anything,
Dr. Keppel? Any other remarks you have about the study?
DR. KEPPEL: Well, the one thing that I might reiterate is that American
Indian Alaska natives fared less well than the other groups that we
considered. There were six indicators that they failed to improve on, and it
really represents a population that is in need of additional preventive
health services, curative health services, and social services.
CDC MODERATOR: And, Dr. Wingo, anything you'd like to add about your article
in the MMWR today on cancer?
DR. WINGO: Sure. I would just like to add to Dr. Keppel's comments that
American Indian Alaskan native populations in cancer do not fare as well as
the other populations that we studied, that their rates--their cancer death
rates for the cancers that we studied, were generally increasing, whereas
the cancer death rates in the other populations that we studied, such as the
whites, blacks, Asian and Pacific Islanders and Hispanics were generally
decreasing for these sites.
So they are the only population that we studied whose cancer death rates
were going in the opposite direction.
CDC MODERATOR: Any questions in the queue?
AT&T MODERATOR: No questions.
CDC MODERATOR: Okay. Well then, that concludes our telebriefing today. If
there are any other questions later, reporters can call the CDC Press Office
at 404-639-3286. Thank you.
AT&T MODERATOR: And, ladies and gentlemen, that does conclude your
conference for today. Thank you for your participation and you may now
disconnect.
