What are Health Disparities?
Health disparities are differences in the incidence, prevalence, and mortality of a disease and the related adverse health conditions that exist among specific population groups. These groups may be characterized by gender, age, race or ethnicity, education, income, social class, disability, geographic location, or sexual orientation. These health disparities are one reason why HIV, viral hepatitis, STDs, and TB take a greater toll in one population group over another. Find information about how these diseases affect African American/Black populations.
Health disparities
HIV
In 2018, African Americans/Blacks accounted for 42% of the 37,968 new HIV diagnoses in the United States and dependent areas. Of the 37,968 new HIV diagnoses in the US and dependent areas in 2018:
- 42% were among adult and adolescent African Americans/Blacks
- 31% were among African American/Black men
- 11% were among African American/Black women
In 2018, in the United States, the death rate for African Americans/Blacks was higher (16.3 per 100,000) compared with any other racial/ethnic group (2.5 Whites). In 2018, African Americans/Blacks represented 43% of all deaths of people diagnosed with HIV. (Note that deaths could be from any cause.) A recent study showed that African Americans/Blacks diagnosed with HIV are less likely than other groups to be linked to care, retained in care, receive antiretroviral treatment, and achieve adequate viral suppression.
In 2018, African American/Black adult and adolescent men accounted for 39% of new HIV diagnoses among men in the United States and dependent areas. Most (79%) new HIV diagnoses among African American/Black men were attributed to male-to-male sexual contact, while 15% were attributed to heterosexual contact.
Among African American/Black adult and adolescent women in the United States and dependent areas, most (92%) new HIV diagnoses were attributed to heterosexual contact in 2018.
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Sexually Transmitted Diseases (STD)
Chlamydia
In 2018, the overall rate of reported chlamydia cases among African American/Black in the United States was 1,192.5 cases per 100,000 population. The rate of reported chlamydia cases among African American/Black females was five times the rate among White females (1,411.1 and 281.7 cases per 100,000 population, respectively. The rate of reported chlamydia cases among African American/Black males was 6.8 times the rate among White males (952.3 and 140.4 cases per 100,000 population, respectively). Rates of reported cases of chlamydia were highest for African Americans/Blacks aged 15–19 and 20–24 years in 2018. The rate of reported chlamydia cases among African American/Black females aged 15–19 years (6,817.3 cases per 100,000 population) was 4.5 times the rate among White females in the same age group (1,520.1 cases per 100,000 population). The rate of reported chlamydia cases among African American/Black females aged 20–24 years was 3.7 times the rate among White females in the same age group (7,087.7 and 1,935.8 cases per 100,000 population, respectively). Among females aged 15–24 years, the population targeted for screening, rates were highest among African Americans/Blacks in all US regions.
Similar racial disparities in reported chlamydia rates exist among males. Among males aged 15–19 years, the rate of reported chlamydia cases among African Americans/Blacks was 9.1 times the rate among Whites (2,668.6 and 293.0 cases per 100,000 population, respectively. The rate of reported chlamydia cases among African American/Black males aged 20–24 years was 5.3 times the rate among White males of the same age group (3,867.1 and 732.6 cases per 100,000 population, respectively).
Gonorrhea
In 2018, the overall rate of reported gonorrhea cases among African Americans/Blacks in the United States was 7.7 times the rate among Whites. This disparity was similar for African American/Black males (8.5 times the rate among White males) and African American/Black females (6.9 times the rate among White females). As in previous years, the disparity in gonorrhea rates for African Americans/Blacks in 2018 was larger in the Midwest and Northeast than in the South and West.
Considering Hispanic ethnicity and all race and age categories, rates of reported gonorrhea cases were highest for African American/Blacks aged 20–24, 15–19, and 25–29 years in 2018. The rate of reported gonorrhea cases among African American/Black females aged 20–24 years (2,040.3 cases per 100,000 population) was 6.9 times the rate among White females in the same age group (297.5 cases per 100,000 population). The rate of reported gonorrhea cases among African American/Black females aged 15–19 years (1,756.4 cases per 100,000 population) was 8.8 times the rate among White females in the same age group (200.1 cases per 100,000 population). Among African American/Black males aged 20–24 years, the rate of reported gonorrhea cases (2,212.1 cases per 100,000 population) was 9.4 times the rate among White males in the same age group (236.3 cases per 100,000 population). The rate of reported gonorrhea cases among African American/Black males aged 25–29 years (1,860.7 cases per 100,000 population) was 7.0 times the rate among White males in the same age group (265.5 cases per 100,000 population).
Primary and Secondary Syphilis
In 2018, 34.7% of reported P&S syphilis cases with known race/Hispanic ethnicity information occurred among African Americans/Blacks. The rate of reported P&S syphilis cases among African Americans/Blacks was 4.7 times the rate among Whites (28.1 versus 6.0 cases per 100,000 population, respectively). This disparity was similar for African American/Black females and males. Similar disparities were seen in all regions of the United States.
Congenital Syphilis
From 2014 to 2018, the rate of reported congenital syphilis increased 126.7% among African Americans/Blacks (38.2 to 86.6 cases per 100,000 live births). In 2018, the rate of reported cases of congenital syphilis among African Americans/Blacks was 6.4 times the rate among Whites (86.6 versus 13.5 per 100,000 live births, respectively).
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Tuberculosis (TB)
In 2018, 87% of all reported TB cases occurred in racial and ethnic minorities. TB disease was reported in 1,799 non-Hispanic African Americans/Blacks in the United States, accounting for 20% of all people reported with TB disease nationally; this proportion is high considering non-Hispanic African Americans/Blacks make up approximately 13% of the U.S. population. While the rates of TB disease in non-Hispanic African Americans/Blacks have been cut in half (from 8.8 cases per 100,000 persons in 2008 compared to 4.4 in 2018) over the past decade, the rate of TB disease in non-Hispanic African Americans/Blacks is over eight times higher than the rate of TB disease in non-Hispanic whites (0.5 cases per 100,000 population). Overall, 9,025 TB cases were reported to CDC from the 50 states and the District of Columbia in 2018.
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