Health Status, Outcomes, and Behaviors

Black people fared worse than White people across the majority of 32 examined measures of health, and AIAN people fared worse on half of the health measures for which data were available for them (Figure 12). In contrast, Asian people had better experiences than White people for most examined health measures. Experiences for Hispanic people were more mixed relative to White people. Data limitations for NHOPI people existed for half of the examined measures, limiting the ability to understand their experiences.

Life Expectancy

At birth, Black people have a shorter life expectancy compared to White people. Life expectancy at birth represents the average number of years a group of infants would live if they were to experience throughout life the age-specific death rates prevailing during a specified period. Provisional data from 2020 show that overall life expectancy across all racial/ethnic groups was 77.3 years (Figure 13). Life expectancy for Black people was only 71.8 years compared to 77.6 years for White people and 78.8 years for Hispanic people. Life expectancy was even lower for Black males at only 68 years. Data were not available for other racial/ethnic groups. Overall life expectancy declined by 1.5 years in 2020, with larger decreases for the Hispanic (3.0 years) and Black (2.9 years) population compared to the White population (1.2 years), largely reflecting the disproportionate impacts of COVID-19 for these groups. Final 2020 data show the overall life expectancy at birth was slightly lower than estimated in the provisional data (77.0 vs 77.3 years), and still show disparities in death rates for Black and Hispanic people.

Self-Reported Health Status

Black, Hispanic, and AIAN adults are more likely to report fair or poor health status than their White counterparts, while Asian adults are less likely to indicate fair or poor health. Nearly one quarter of AIAN adults (23%) and nearly two in ten Hispanic (19%) and Black (18%) adults reported fair or poor health status compared to 13% of White adults (Figure 14). In contrast, 6% of Asian adults reported fair or poor health status.

AIAN adults are more likely to report having 14 or more unhealthy days within the past 30 days than White adults, while Asian adults are less likely than their White counterparts (Figure 15). AIAN adults had the highest rates of 14 or more physically (16%) and mentally (19%) unhealthy days in the past 30 days, compared to White adults (10% and 14%, respectively). In contrast, Asian adults had the lowest rates of 14 or more physically (4%) and mentally (7%) unhealthy days.

Birth Risks and Outcomes

People of color are more likely to experience certain birth risks and adverse birth outcomes compared to White people. Specifically, higher shares of births to Black, Hispanic, AIAN and NHOPI people were preterm, low birthweight, and among those who received late or no prenatal care compared to White people (Figure 16). Asian people were also more likely to have low birthweight births than White people.

Moreover, the birth rate among Black, Hispanic, AIAN, and NHOPI teens was over two times higher than the rate among White teens (Figure 17). In contrast, the birth rate for Asian teens was over four times lower than the rate for White teens.

Similarly, Black and NHOPI infants were two times as likely to die as White infants (10.8 and 9.4 per 1,000 compared to 4.6 per 1,000) (Figure 18). AIAN infants also had a higher mortality rate than White infants (8.2 vs. 4.6 per 1,000). Asian infants had the lowest mortality rate (3.6 per 1,000).

Black and AIAN people were more likely to die while pregnant or within a year of the end of pregnancy compared to White people (Figure 19). Hispanic people had the lowest pregnancy-related mortality rates (11.5 per 100,000).

HIV and AIDS Diagnosis and Deaths

Black, Hispanic, NHOPI and Asian people are more likely to be diagnosed with HIV or AIDS than White people. As of 2019, the HIV and AIDS diagnosis rates for Black people were roughly nine times higher than the rates for White people, and the rates for Hispanic people were about four times higher than the rates for White people (Figure 20). AIAN and NHOPI people also had higher HIV and AIDS diagnosis rates compared to White people. Most groups have seen decreases in HIV and AIDS diagnosis rates since 2013, although the HIV diagnosis rate has increased for AIAN and NHOPI people.

Among people diagnosed with HIV, Black and Hispanic people are also more likely to die than their White counterparts. Black people diagnosed with HIV were nearly seven times as likely to die compared to White people, and the death rate for Hispanic people with HIV was nearly twice as high as the rate for White people (Figure 21). In contrast, Asian people with HIV had a lower death rate compared to White people. The death rate among people with HIV has remained fairly stable for most groups since 2013, except for an increase among Black people over the period.

Chronic Disease and Cancer

Prevalence of chronic disease varies across racial and ethnic groups and by type of disease. As of 2020, diabetes rates for Black (15%), Hispanic (12%), and AIAN (14%) adults were all higher than the rate for White adults (10%), while Asian adults had a lower rate (7%). Black (6%), Hispanic (4%) and Asian (2%) adults were less likely to have had a heart attack or heart disease than White adults (7%). Black and AIAN adults had higher rates of asthma compared to their White counterparts (11% and 14% vs. 9%), while Hispanic and Asian adults had lower asthma rates than White adults (8% and 5% vs. 9%). Among children, in 2019, Black children were twice as likely to have asthma compared to White children (18% vs 9%), while differences were not significant for other racial/ethnic groups; disaggregated data were not available for NHOPI children (Figure 22).

AIAN and Black people are twice as likely as White people to die from diabetes, and Black people are also more likely than White people to die from heart disease (Figure 23). In 2019, the age-adjusted mortality rates for diabetes for AIAN and Black people were twice as high as the rate for White people (41.5 and 28.2 per 100,000 people vs. 19 per 100,000 people). Hispanic people also had a higher diabetes death rate compared to White people (25.6 vs. 19.0 per 100,000 people). In contrast, Asian and Pacific Islander people (as a combined group) were less likely than White people to die from diabetes. Black and AIAN people also had higher age-adjusted heart disease death rates than White people, while Hispanic and Asian and Pacific Islander people (as a combined group) had lower death rates.

People of color generally have lower rates of new cancer cases compared to White people, but Black people have higher cancer incidence rates for some cancer types (Figure 24). As of 2018, Black people had similar or lower rates of cancer incidence compared to White people for cancer overall and most of the leading types of cancer examined. However, they had higher rates of new colon and rectum and prostate cancer. Other groups had lower cancer incidence rates than White people across all examined cancer types.

Although Black people do not have higher cancer incidence rates than White people overall and across most types of cancer that were examined, they are more likely to die from cancer. Black people had a higher cancer death rate than White people for cancer overall and for all the leading cancer types examined as of 2018 (Figure 25). In contrast, Hispanic, Asian and Pacific Islander, and AIAN people had lower cancer mortality rates compared to White people. The higher mortality rate among Black people despite similar or lower rates of incidence compared to White people may reflect a combination of factors, including more limited access to care, later stage of diagnosis, more comorbidities, and lower receipt of guideline-concordant care, which are driven by broader social and economic inequities.

Smoking, Obesity, and Substance Use

Smoking, obesity, alcohol or illicit drug dependence or abuse rates vary across racial/ethnic groups. As of 2020, AIAN and Black adults (26% and 17%, respectively) were more likely to smoke than White adults (15%), while Asian and Hispanic adults (7% and 11%, respectively) had lower smoking rates. Black (42%), AIAN (39%), NHOPI (38%), and Hispanic (37%) adults all had higher obesity rates than White adults (31%), while Asian adults had a lower obesity rate at 12%. Hispanic and Asian adults had lower rates of alcohol or illicit drug dependence or abuse than White adults (Figure 26).

Health Coverage and Access to and Use of Care Social Determinants of Health

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