The African American population in general is facing an unprecedented health crisis. They are medically underserved, in poor health, and many lack health insurance. Their health status is, by all indicators, declining. "Ethnic and racial groups continue to bear a disproportionate burden of mortality and morbidity across a wide range of health conditions, a situation further compounded by reduced access to health care services. Cultural competency and health care literacy, race and ethnicity influence a patient's chance of receiving many specific procedures and treatments. Poverty and lack of health education are the cornerstones of the health needs of the African American community" (Report from Kaiser Family Foundation and the UCLA Center for Health Policy Research). One of every five San Bernardino County residents lacks health care insurance, according to UCLA. The rate of local residents who are uninsured is one of the highest in the nation and results in large portions of the local populace losing access to vital health care services. Nonworking individuals and those that are working for low wages have no access to specialty medical care. They have difficulty gaining access to primary health care. Those who have access often are dissatisfied with the level of personal clinical attention. Often simple problems are ignored or postponed because there are no alternatives. This leads to expensive curative solutions. Access to affordable quality health care and the need to provide effective public transportation to health care services is a component of searching for best practice models. Housing in rural communities is cheaper than in urban areas, and many non-working families or working poor families often migrate to these areas. The concentration of health care providers is found within the more heavily populated cities of San Bernardino County (i.e. City of San Bernardino, Victorville, Barstow, and Redlands). Without adequate transportation, access to reliable medical care presents a major barrier to lower income families.

 

At Birth:

	Infant mortality is more than twice as high among African Americans than Whites, and more than 1.5 times higher than Native Americans.
	More than twice as many African American babies are born underweight than White babies.
	A White boy has a life expectancy of 74 years; 66 years for an African-American boy.
	A White girl has a life expectancy of 80 years; just over 74 for an African American girl.

 

As Children:

	African American infants were more than twice as likely to die of Sudden Infant Death Syndrome (SIDS) as White infants; four times as likely than Hispanics.
	African American children lack health insurance at a rate of 19%, compared with 11% Whites
	Of uninsured African American Children ages 0-5, 10% have not visited a physician during a 12 month period, while 20% of uninsured children ages 6-17 have not seen a physician in the last two years

 

As Adults:

	One in four (25%) of African Americans rate their health as fair or poor, compared to 18% among Whites.
	AIDS is the number one killer of African Americans in the prime of their lives (between 25-44 years).
	One in four African American men and one in 160 women are AIDS infected.
	23% of African Americans are uninsured, 1 and ½ times the uninsured rate for Whites.
	African American women are less likely to get breast cancer, but more likely to die from it.
	African American men are 38% more likely to get prostate cancer than their White counterparts, and twice as likely to die from it.
	Hypertension statistics among African Americans reveal incidence levels almost double that of Whites and Hispanics.
	Historically, proper medical care was not available to African Americans; today, many are not aware of medical options and resources

 

Health Problems Affecting African Americans

Heart Disease/Stroke/Hypertension:

· Hypertension statistics among African Americans reveal incidence levels almost double that of Whites and Hispanics.
· Diabetes is a major contributing factor to heart disease. African Americans have a prevalence of diabetes that is about 70% higher than Whites. Diabetes increased the mortality of African Americans with heart disease by more than three times, compared with more widely recognized risk factors such as high blood pressure, smoking, high cholesterol and obesity.
· African Americans are 13% less likely to undergo coronary angioplasty and one-third less likely to undergo bypass surgery than Whites.
· African American Medicare patients hospitalized for heart attacks were 16% less likely than Whites to receive anticoagulation medication within the first few hours after a heart attack; and 6% less likely to leave the hospital with prescriptions for beta-blocking drugs, despite the fact that this regimen constitutes the standard course of care.

· Prostate cancer is the single most common form of non-skin cancer in men in the US. In 2000, 180,400 men were diagnosed with prostate cancer and 31,900 died of the disease. Prostate cancer exacts a particularly high toll on African-American men - mortality rates are more than twice as high as rates in White men. Relative survival rates have increased since 1973 for both Black and White men, however, survival has not improved as rapidly in Black men.
· Breast cancer is the most common form of cancer among women in the US. The incidence of breast cancer has been rising for the past two decades, while mortality has remained relatively stable since the 1950s. The highest age-adjusted mortality occurs among Black women, followed by White, and Hawaiian women. The higher breast cancer mortality among Black women is related to a larger percentage of breast cancer diagnosis at a later, less treatable stage as compared to White women.
(Source: National Cancer Institute)

HIV/AIDS:

• AIDS is the number one killer of African Americans in the prime of their lives (between 25-44 years). One in four African American men and one in 160 women are AIDS infected nationwide.
  
• White persons diagnosed with AIDS live longer on average than African Americans who have died, indicating barriers to care among people of color or by delays in seeking care.
  
• African Americans with HIV infection are less likely to be on antiretroviral therapy, less likely to receive prophylaxis for pneumocystis pneumonia, and are less likely to receive protease inhibitors than other persons with HIV.2000 Census Data for San Bernardino County, Reported AIDS Cases for Persons of Color and updated January 23, 2002. Census
• Data: According to the United States Census Bureau, in the year 2000 San Bernardino County had a population of 1,709,434. The number of persons of color and corresponding proportion of the population are as follows:
  

Racial/Ethnic Group	San Bernardino	% Population
African American	150,201	9
Latino	669,387	39
Asian/Pac Islander	82,541	5
Native American	9,804	1
Other	45,279	3
Total	957,212	56%

According to the AIDS case registry of San Bernardino County, 2,870 cases had been reported as of Decemer 31, 2001.  The number of persons of color reported with AIDS and proportion of all reported cases are as follows:

Racial/Ethnic Group	San Bernardino	% Population
Black, not Hispanic	689	24
Hispanic	778	27
Asian/Pac Islander	32	1
American Indian	22	1
Total	1,521	53%

 

Leading Causes of Death by Age Group Among San Bernardino County African American Residents:

Cause of Death All Ages Decedent's Age <25 25-34 35-44 45-54 55-64 65+ Number Percent Number Percent Number Percent Number Percent Number Percent Number Percent Number Percent All Causes 832 100.0 73 100.0 36 100.0 79 100.0 95 100.0 143 100.0 406 100.0 Residual (all other causes) 565 67.9 72 98.6 34 94.4 56 70.9 61 64.2 92 64.3 250 61.6 HIV disease 9 1.1 0 0 0 0 5 6.3 3 3.2 1 0.7 0 0 Breast cancer 16 1.9 0 0 0 0 1 1.3 6 6.3 8 5.6 1 0.2 Prostate cancer 10 1.2 0 0 0 0 0 0 1 1.1 0 0 9 2.2 Hypertensive diseases 11 1.3 0 0 0 0 1 1.3 1 1.1 3 2.1 6 1.5 Diseases of the heart 221 26.6 1 1.4 2 5.6 16 20.3 23 24.2 39 27.3 140 34.5

Source:  San Bernardino County Department of Public Health