All children struggle through battles with the common cold, flu and fevers. As parents, we wipe their runny noses and take their temperature, offering them comfort as they heal, knowing that it’s just another part of growing up. However, when your child battles a chronic, life-threatening disease, such as asthma, diabetes or cancer, the stakes are much higher. In those cases, parents are then forced to rely on physicians, medications and long-term treatment in order to provide even the most basic care for the child.
Children are the most vulnerable population within the diverse ethnic communities of African-Americans, Hispanics, American Indians and Asian Americans, and they suffer disproportionately from preventable diseases, they have higher rates of asthma, diabetes, cancer and lower rates of immunizations than white Americans. Tackling the unacceptable healthcare inequalities in our country, various government and non-profit agencies have stepped up their efforts to eliminate health disparities among the minority populations. These agencies include the National Institutes of Health, the American Academy of Pediatrics and the Center for Disease Control and Prevention (CDC), who all fight to protect our most treasured hope for the future: Our nation’s children.
Asthma
An estimated 6.5 million children suffer from asthma, an inflammation of the airways resulting in labored breathing, chest constriction, and characterized by episodes of airflow obstruction. Crossing racial lines, it is the most common chronic illness affecting children in the United States, and is the leading cause of school absenteeism. However, African-Americans have the highest prevalence of asthma, with 13 percent of all black children affected by the disease, compared to 8 percent of white children.
Although asthma cannot be cured, it can be controlled through proper diagnosis and treatment. Due to a lack of access to healthcare and healthcare education, both black and Hispanic children were less likely than white children to use daily inhaled anti-inflammatory medications that help prevent asthma flare-ups, according to a 2002 Harvard Medical School study. In addition, although mortality and hospitalizations due to asthma have decreased overall among children in the last few years, African-American children are at greater risk than either white or Hispanic children to have their asthma symptoms escalate into an emergency. The most frightening statistic for parents is that black asthmatic children are six times more likely to die from this disease than white children.
To combat asthma, the American Academy of Pediatrics has developed the “Schooled in Asthma” project, encouraging pediatricians to incorporate school health concepts with current asthma treatment guidelines. The CDC aims to reduce the number of deaths and hospitalizations through the “Healthy People for 2010” Program, with a focus on implementing community-driven coalition’s that actively promote continuing education about asthma.
Obesity
Over the last 20 years, obesity has risen sharply in the United States, becoming the most common health problem facing our children. According to the Journal of the American Medical Association, obesity is a particular problem for African-American and Hispanic children. Today, 25 percent of African American children are overweight, compared to 22 percent of Hispanic children and 12 percent of white children. Since the primary risk factor for type 2 diabetes is obesity, diabetes is now the second most common chronic illness affecting our nation’s children. Diabetes is the leading cause of kidney failure and blindness, and puts those who suffer from the disease at a significantly higher risk of heart disease and stroke. Minority groups have up to 10 times the rate of diabetes as Caucasians. Native Americans, and their children, are particularly susceptible to the disease. Children who fall into the high risk groups, even those who are diagnosed as pre-diabetic, can prevent or delay the onset of the disease by losing 5 to 7 percent of their body weight, getting 30 minutes of physical activity five days a week, and eating the right portions of healthy foods.
One group of Native Americans, the Pima Indians of southern Arizona, are doing more than their part to solve the genetic and lifestyle puzzle of obesity and diabetes. Since 1963, scientists from the National Institutes of Health have worked cooperatively with the Pima Indians to search for the root causes of the disease through several generations of Pima families. Scientists hope their studies will break the codes that cause insulin resistance, obesity and diabetes, and locate the genes that will enable doctors to identify youngsters at risk and begin prevention before the disease sets in.
Cancer
Nationwide, childhood cancer accounts for 1 percent of all new cancer cases, but the American Cancer Society estimates that 2.3 percent of Hispanic children were diagnosed with cancer in 2006. The incidence rate for leukemia, the most common childhood cancer, is a whopping 17 percent higher among Hispanic children, compared to non-Hispanic, white children. Cancer is the third leading cause of death for African-American youth, with over 200 children dying from the disease every year. Due to significant advances in cancer treatment, cancer survival rates among children of all races and ethnicities have improved. However, Hispanic children have a lower five-year survival rate than white children. This can be attributed to several factors, including a lack of insurance, limited access to treatment and barriers related to language and culture. Nearly one-quarter of Hispanic children over the age of five do not speak English fluently. Early detection of cancer is the single most important factor for successfully treating the disease, but many Asian American youth are at a severe disadvantage, since nearly one-third of them do not receive routine healthcare.
The Centers for Medicare and Medicaid Services are actively working to improve the early detection and treatment of cancer in order to reduce health disparities among minority Medicare beneficiaries. In addition, the American Cancer Society now collaborates with the Asian American Network for Cancer Awareness to provide a searchable online database of Asian language cancer materials.
Immunizations and Insurance
While vaccine preventable diseases are at near record lows in the United States, there are still frustrating inequities in the extent to which minority youth receive the full sequence of immunizations necessary to protect them from serious illnesses. While 80 percent of U.S. children receive the recommended combined vaccination series to prevent diseases such as measles, mumps, rubella, polio and chicken pox, African-American and Hispanic children were less likely to be fully immunized, due in part to a lack of education on the necessity of the shots for the overall long-term health of the child.
Many studies have shown that children with health insurance are more likely to have regular and accessible healthcare than children without it. However, minorities experience an unequal share of financial barriers resulting from higher rates of uninsuredness and a greater reliance on Medicaid. The Hispanic population is hit hardest by the lack of insurance. Only 79 percent of Hispanic children were covered by health insurance, compared to 90 percent of white children and 88 percent of Black children.
Our nation’s health care experts are focused on the overwhelming prevalence of chronic diseases affecting children in minority groups, and are taking steps to address the gaps in healthcare for this underserved population. In 2006, the National Leadership Summit on Racial and Ethnic Health Disparities brought 2,000 health experts and community leaders together to review the long journey toward equality in health outcomes for minorities. The National Partnership for Action was formed to focus on the health status and outcomes of minorities in order to produce a nation free of health disparities, with quality health care for all. R.E.A.C.H. (Racial and Ethnic Approaches to Community Health) is the cornerstone of the CDC’s efforts to address the unique needs of racial and ethnic groups. The CDC has also formed a Division of Adolescent and School Health (DASH) program aimed at preventing the most serious health risks among youth.
It’s inevitable that every child will battle the occasional childhood illness, but it’s unacceptable that certain minority youth in America are unduly affected by chronic illness, which is preventable through access to quality healthcare. The investment of time, money and education by government agencies and community coalitions can empower families to take advantage of dramatic advances in medical technology and care. Health disparities must be erased so that no American child will suffer needlessly from a disease.