Skip to main content
PMC home page
Public Health Reports logoLink to Public Health Reports
. 2001 Sep-Oct;116(5):484–494. doi: 10.1016/S0033-3549(04)50076-6

Evaluating Chicago's success in reaching the Healthy People 2000 goal of reducing health disparities.

A Silva 1, S Whitman 1, H Margellos 1, D Ansell 1
PMCID: PMC1497369  PMID: 12042612

Abstract

OBJECTIVE: This study was designed to assess Chicago's progress from 1980 to 1998 in addressing the Healthy People 2000 goal of reducing health disparities. METHODS: Chicago vital statistics and surveillance data were used to calculate black:white rate ratios of mortality and morbidity for 1980-1998. Mortality and morbidity rate ratios were also used to compare people living in areas with the lowest median household income with those living in the highest for 1979-1981, 1991-1993, and 1996-1998. The health measures included mortality associated with leading causes of death; all-cause mortality, incidence rates for two communicable diseases; and two birth outcomes. RESULTS: Both black:white and low-income:high-income rate ratios monotonically increased for virtually all measures of mortality and morbidity. Almost all of the rate ratios and linear trends were statistically significant. From 1980 to 1998, the black:white rate ratio for all-cause mortality increased by 57% to 2.03. From 1979-1981 to 1996-1998, the low-income:high-income rate ratio for all-cause mortality increased by 56% to 2.68. CONCLUSIONS: These findings provide clear evidence that disparities in health did not decrease in Chicago. Instead, racial and economic disparities increased for almost all measures of mortality and morbidity used in this study. The fact that the Healthy People 2000 campaign to reduce and then eliminate health disparities was not effective must serve as a stimulus for improved strategies.

Full Text

The Full Text of this article is available as a PDF (130.5 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Buechner J. S. Health disparities among racial and ethnic groups in Rhode Island. Med Health R I. 2000 Aug;83(8):257–258. [PubMed] [Google Scholar]
  2. Cohen H. W., Northridge M. E. Getting political: racism and urban health. Am J Public Health. 2000 Jun;90(6):841–842. doi: 10.2105/ajph.90.6.841. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Cohen O. J., Fauci A. S. Current strategies in the treatment of HIV infection. Adv Intern Med. 2001;46:207–246. [PubMed] [Google Scholar]
  4. Collins C. A. Racism and health: segregation and causes of death amenable to medical intervention in major U.S. cities. Ann N Y Acad Sci. 1999;896:396–398. doi: 10.1111/j.1749-6632.1999.tb08152.x. [DOI] [PubMed] [Google Scholar]
  5. Cooper R. S. Health and the social status of blacks in the United States. Ann Epidemiol. 1993 Mar;3(2):137–144. doi: 10.1016/1047-2797(93)90126-o. [DOI] [PubMed] [Google Scholar]
  6. Cooper R., David R. The biological concept of race and its application to public health and epidemiology. J Health Polit Policy Law. 1986 Spring;11(1):97–116. doi: 10.1215/03616878-11-1-97. [DOI] [PubMed] [Google Scholar]
  7. Davey Smith G., Neaton J. D., Wentworth D., Stamler R., Stamler J. Mortality differences between black and white men in the USA: contribution of income and other risk factors among men screened for the MRFIT. MRFIT Research Group. Multiple Risk Factor Intervention Trial. Lancet. 1998 Mar 28;351(9107):934–939. doi: 10.1016/s0140-6736(00)80010-0. [DOI] [PubMed] [Google Scholar]
  8. Dutcher J. P., Novik Y., O'Boyle K., Marcoullis G., Secco C., Wiernik P. H. 20th-century advances in drug therapy in oncology--Part I. J Clin Pharmacol. 2000 Sep;40(9):1007–1024. doi: 10.1177/00912700022009620. [DOI] [PubMed] [Google Scholar]
  9. Geronimus A. T., Bound J., Waidmann T. A., Hillemeier M. M., Burns P. B. Excess mortality among blacks and whites in the United States. N Engl J Med. 1996 Nov 21;335(21):1552–1558. doi: 10.1056/NEJM199611213352102. [DOI] [PubMed] [Google Scholar]
  10. Geronimus A. T., Bound J., Waidmann T. A. Poverty, time, and place: variation in excess mortality across selected US populations, 1980-1990. J Epidemiol Community Health. 1999 Jun;53(6):325–334. doi: 10.1136/jech.53.6.325. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Geronimus A. T. To mitigate, resist, or undo: addressing structural influences on the health of urban populations. Am J Public Health. 2000 Jun;90(6):867–872. doi: 10.2105/ajph.90.6.867. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Gueyffier F., Froment A., Gouton M. New meta-analysis of treatment trials of hypertension: improving the estimate of therapeutic benefit. J Hum Hypertens. 1996 Jan;10(1):1–8. [PubMed] [Google Scholar]
  13. Kaplan G. A., Lynch J. W. Is economic policy health policy? Am J Public Health. 2001 Mar;91(3):351–353. doi: 10.2105/ajph.91.3.351. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Krieger N., Fee E. Social class: the missing link in U.S. health data. Int J Health Serv. 1994;24(1):25–44. doi: 10.2190/2JG7-YMD5-WCP2-XXNT. [DOI] [PubMed] [Google Scholar]
  15. Krieger N., Rowley D. L., Herman A. A., Avery B., Phillips M. T. Racism, sexism, and social class: implications for studies of health, disease, and well-being. Am J Prev Med. 1993 Nov-Dec;9(6 Suppl):82–122. [PubMed] [Google Scholar]
  16. Krieger N., Williams D. R., Moss N. E. Measuring social class in US public health research: concepts, methodologies, and guidelines. Annu Rev Public Health. 1997;18:341–378. doi: 10.1146/annurev.publhealth.18.1.341. [DOI] [PubMed] [Google Scholar]
  17. Lantz P. M., House J. S., Lepkowski J. M., Williams D. R., Mero R. P., Chen J. Socioeconomic factors, health behaviors, and mortality: results from a nationally representative prospective study of US adults. JAMA. 1998 Jun 3;279(21):1703–1708. doi: 10.1001/jama.279.21.1703. [DOI] [PubMed] [Google Scholar]
  18. Link B. G., Phelan J. Social conditions as fundamental causes of disease. J Health Soc Behav. 1995;Spec No:80–94. [PubMed] [Google Scholar]
  19. Mansfield C. J., Kirk D., Curry M. D., Bobbitt-Cooke M. The challenge of eliminating health disparities in North Carolina. N C Med J. 2001 Jan-Feb;62(1):19–25. [PubMed] [Google Scholar]
  20. Mason J. O. Understanding the disparities in morbidity and mortality among racial and ethnic groups in the United States. Ann Epidemiol. 1993 Mar;3(2):120–124. doi: 10.1016/1047-2797(93)90122-k. [DOI] [PubMed] [Google Scholar]
  21. McCord C., Freeman H. P. Excess mortality in Harlem. N Engl J Med. 1990 Jan 18;322(3):173–177. doi: 10.1056/NEJM199001183220306. [DOI] [PubMed] [Google Scholar]
  22. McNamara K. M. Racial disparities in health: a sociological analysis. J S C Med Assoc. 1999 Mar;95(3):95–98. [PubMed] [Google Scholar]
  23. Moss N. Socioeconomic disparities in health in the US: an agenda for action. Soc Sci Med. 2000 Dec;51(11):1627–1638. doi: 10.1016/s0277-9536(00)00058-7. [DOI] [PubMed] [Google Scholar]
  24. Ng-Mak D. S., Dohrenwend B. P., Abraido-Lanza A. F., Turner J. B. A further analysis of race differences in the National Longitudinal Mortality Study. Am J Public Health. 1999 Nov;89(11):1748–1751. doi: 10.2105/ajph.89.11.1748. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Pappas G., Queen S., Hadden W., Fisher G. The increasing disparity in mortality between socioeconomic groups in the United States, 1960 and 1986. N Engl J Med. 1993 Jul 8;329(2):103–109. doi: 10.1056/NEJM199307083290207. [DOI] [PubMed] [Google Scholar]
  26. Polednak A. P. Black-white differences in sentinel causes of death: counties in large metropolitan areas. J Urban Health. 2000 Sep;77(3):501–507. doi: 10.1007/BF02386757. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Polednak A. P. Mortality in Hartford, Connecticut: a comparison with the South Bronx, New York. J Urban Health. 1998 Sep;75(3):550–557. doi: 10.1007/BF02427703. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Polednak A. P. Segregation, discrimination and mortality in U.S. blacks. Ethn Dis. 1996 Winter-Spring;6(1-2):99–108. [PubMed] [Google Scholar]
  29. Ren X. S., Amick B. C. Racial and ethnic disparities in self-assessed health status: evidence from the National Survey of Families and Households. Ethn Health. 1996 Sep;1(3):293–303. doi: 10.1080/13557858.1996.9961798. [DOI] [PubMed] [Google Scholar]
  30. Ren X. S., Amick B. C., Williams D. R. Racial/ethnic disparities in health: the interplay between discrimination and socioeconomic status. Ethn Dis. 1999 Spring-Summer;9(2):151–165. [PubMed] [Google Scholar]
  31. Sakamoto S., Takeda Y., Nakabayashi M. Advances in perinatal medical care--from our experience. Int J Gynaecol Obstet. 1998 Dec;63 (Suppl 1):S107–S114. doi: 10.1016/s0020-7292(98)00192-1. [DOI] [PubMed] [Google Scholar]
  32. Sorlie P. D., Backlund E., Keller J. B. US mortality by economic, demographic, and social characteristics: the National Longitudinal Mortality Study. Am J Public Health. 1995 Jul;85(7):949–956. doi: 10.2105/ajph.85.7.949. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Susser M. The logic in ecological: I. The logic of analysis. Am J Public Health. 1994 May;84(5):825–829. doi: 10.2105/ajph.84.5.825. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Walker B., Figgs L. W., Zahm S. H. Differences in cancer incidence, mortality, and survival between African Americans and whites. Environ Health Perspect. 1995 Nov;103 (Suppl 8):275–281. doi: 10.1289/ehp.95103s8275. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Williams D. R. Race, socioeconomic status, and health. The added effects of racism and discrimination. Ann N Y Acad Sci. 1999;896:173–188. doi: 10.1111/j.1749-6632.1999.tb08114.x. [DOI] [PubMed] [Google Scholar]
  36. Williams D. R. Racism and health: a research agenda. Ethn Dis. 1996 Winter-Spring;6(1-2):1–8. [PubMed] [Google Scholar]

Articles from Public Health Reports are provided here courtesy of SAGE Publications

RESOURCES