Addressing Sexual and Reproductive Health Disparities among African Americans
African Americans face greater obstacles to obtaining sexual and reproductive health services than non-Hispanic white Americans. As a result, African Americans experience higher rates of reproductive cancers, unintended pregnancy, and sexually transmitted infections than most other groups of Americans. Moreover, African American patients are often diagnosed later than are others with the same health problems, and they have less access to high-quality, affordable care, resulting in higher death rates from the same conditions. For example: Reproductive Cancers • Among women diagnosed with breast cancer, African American women are most likely to die from the disease (ACS, 2015). African American women are 40 percent more likely to die of breast cancer than white women (CDC, 2012). Survival is lower for African American women than for white women at every stage of diagnosis (ACS, 2015). • African American women are twice as likely to lose their lives to cervical cancer as are non-Hispanic white women (ACS, 2015). Unintended and Teen Pregnancies • African American women have more than double the unintended pregnancy rate of white women. As a result, African American women also have higher rates of abortion (Finer and Zolna, 2014). • African American teens aged 15–19 have higher rates of pregnancy, birth, and abortion than non-Hispanic white teens (Kost and Henshaw, 2014). • While at a historic low, the birth rate for African American teens is more than twice that of non-Hispanic white teens (Martin et al., 2015). Sexually Transmitted Infections • In 2010, African Americans, while representing 12 percent of the U.S. population, accounted for 44 percent of new HIV/AIDS infections (CDC, 2014a). In 2013, they accounted for 47 percent of new gonorrhea cases, 31 percent of new chlamydia cases, 44 percent of new HIV/ AIDS infections, and 38 percent of primary and secondary syphilis cases (CDC, 2014b). • African Americans are six times as likely as non-Hispanic whites to be diagnosed with chlamydia, 12 times as likely to be diagnosed with gonorrhea, and five and a half times as likely to be diagnosed with primary and secondary syphilis (CDC, 2014b). Health Insurance • In 2013, 49.6 percent of African Americans, in comparison to 72.1 percent of non-Hispanic whites, used private health insurance (Smith and Medalia, 2014). • In 2013, 15.9 percent of African Americans were uninsured, as compared to 9.8 percent of non-Hispanic whites (Smith and Medalia, 2014). • African American women are more likely to be uninsured (19 percent) or under-insured than white women, and they often are forced to delay care because they lack the resources to pay for it. There are approximately 6.5 million uninsured African Americans (Smith and Medalia, 2014; KFF, 2014; Salganicoff et al., 2014).
Addressing Sexual and Reproductive Health Disparities among African Americans Non-Reproductive Health • The African American infant mortality rate is more than twice as high as that for white infants (Mathews and MacDorman, 2013). • The death rate for cancer among African American women is 14 percent higher than among non-Hispanic white women; for African American men, it is 29 percent higher than among non-Hispanic white men (ACS, 2015). • In 2010, life expectancy for the African American population was 3.8 years lower than that of the white population due to higher death rates for the black population for heart disease, cancer, homicide, diabetes, and perinatal conditions (Kochanek, et al., 2013). • African American babies are almost twice as likely as non-Hispanic white or Latino babies to be born at low birth weight (Martin et al., 2015). • Twenty-two percent of African Americans did not have a usual source of health care (NCHS, 2014). Education • In 2013, just 17 percent of the nation’s African American eighth graders tested proficient in reading — nearly three times fewer than the number of white students taking the test (NCES, 2013). • In 2013, 22 percent of African Americans were college graduates, as compared to 36 percent of whites (U.S. Census Bureau, n.d.). Economics • The wealth of white households is 13 times greater than that of African American households (Kochhar and Fry, 2014). • In 2011, African American families in the United States had a median net worth of $6,314, only 5.7 percent of the $110,500 median non-Hispanic white net worth (U.S. Census Bureau, 2013). • African American home owners are almost three times more likely to receive higher-rate loan terms and twice as likely to receive a lone with a prepayment penalty than white borrowers, despite evidence that many of these borrowers could have qualified for more affordable and fair loans (Center for Responsible Lending, 2012). • African American children are the group of children most likely to be poor. Approximately one in five African American children was living in extreme poverty in 2012 compared to one in 18 non-Hispanic white children (CDF, 2014). • While white women in the prime working years of ages 36–49 have a median wealth of $42,600 (still only 61 percent of their white male counterparts), the median wealth for women of color is only $5 (Insight Center for Community Economic Development, 2010). • For African Americans, the 2013 poverty rate was 27.2 percent, which represents 10.9 million people in poverty (DeNavas-Walt and Proctor, 2014)