(Not So) Gently Down the Stream: Choosing Targets to Ameliorate Health Disparities (Editorial‪)‬

Health disparities in the United States exist by race and ethnicity, gender, age, disability status, sexual orientation, socioeconomic status (SES), and geography and can occur in screening, incidence, mortality, survivorship, and treatment. The Framingham Heart Study, for example, found that 35 percent of women suffered a second heart attack compared with 18 percent of men. Explanations for this particular gender disparity have focused mainly on differentials in treatment. A 2005 study by Mosca and colleagues, for instance, found that women are 55 percent less likely than men to receive cardiac rehabilitation following a heart attack. The authors attribute this to the failure of physicians to take women's symptoms as seriously as they do those of men. To date, disparities by race and ethnicity have received the most attention among group differences in health and have been noted for all major diseases. Ethnic minority children, for example, are more likely than are white children to have asthma. According to the National Center for Health Statistics, in 2004 and 2005 Puerto Rican and non-Hispanic black children had higher rates of the disease than did non-Hispanic white children (12.7 percent among non-Hispanic black children, 19.2 percent among Puerto Rican children, and 8 percent among non-Hispanic white children) (Akinbami, 2006). Racial and ethnic disparities in incidence and mortality also occur for cancer (Reis et al., 2007), diabetes (Centers for Disease Control and Prevention, n.d.), and cardiovascular disease (Centers for Disease Control and Prevention, 2005).