Public Health Quiz

African-Americans also have a 30 percent higher death rate for all cancers and are seven times more likely to die from AIDS. Twenty percent of all new cases of tuberculosis (TB) are found in Hispanics. Hispanics also have a high rate of obesity and hypertension. Asian Americans and Pacific Islanders have higher rates of TB and hepatitis.

The APHA looks at disparities among racial, ethnic, and gender groups in disease, disabilities, and death for cardiovascular disease, diabetes, breast/cervical cancer, HIV/AIDS, immunization, and infant mortality.

Other examples: African-Americans have a 10 percent higher incidence rate of cancer than whites. Hispanics have higher rates of esophageal, gallbladder, and stomach cancer than whites. Whites have a higher incidence rate of leukemia than African-Americans.

The death rate per 100,000 people for American Indians and Alaskan natives is 127. The cancer death rate for whites is 203. For other groups, the cancer death rate is 121 for Hispanics; 125 for Asians and Pacific Islanders; and 250 for African-Americans.

Other potential reasons: geography (women who live in rural areas may find it more difficult to travel to a cancer center for treatment); health literacy (women who have difficulty with English or cultural differences may not get screening or treatment); and poverty (women who live in poverty have a 10 to 15 percent lower survival rate, according to the American Cancer Society).

The incidence rate for women is 1 in 3. The death rate for heart disease in men is 49 percent higher than for women. By race and ethnicity, African-American men are twice as likely to die from heart disease as Hispanic men. White men have a higher incidence of heart disease than do Asians, American Indians, and Hispanics.

Other potential reasons: obesity (53 percent of African-American women are obese vs. 34 percent of white women); income (people with higher incomes are more likely to get their blood pressure and cholesterol checked); and education (people with more education are more likely to get their blood pressure checked and have it under control).

Over all, nearly 28,000 infants died before their first birthday in 2000, the latest year that statistics are available. The rate for African-Americans is 13.6 deaths per 1,000 births. For other groups, the rate is 8.2 for American Indians; 5.7 for whites; 5.6 for Hispanics; and 4.8 for Asians. The rate of sudden infant death syndrome among African American infants is twice that of white infants.

Cigarette smoking is associated with low birth weight and growth retardation. American Indian women have the highest rate of smoking; Asians and Pacific Islanders have the lowest rate. Alcohol has a deleterious affect on the developing fetus. Whites and American Indians have the highest rate of alcohol consumption; Asians have the lowest. Cultural differences can make pregnancy and birth more difficult. Mexican American women report feeling more stress and getting less support from the baby's father. Other potential reasons include unintended pregnancy, obesity, and lack of prenatal care.

Most of the extra cost was for reproductive health-related supplies and services. In 1998, the APHA says, more than half of all Viagra prescriptions were reimbursed, which was more than the reimbursement for diaphragms and IUDs. In disease comparisons, men have a life expectancy that is six years less than for women. Men are twice as likely to die from unintentional injuries and four times as likely to die from firearms-related injuries. Women are at greater risk for Alzheimer's disease and are twice as likely to develop major depression.