Spiritual_Wellness_Holistic_Health_and_the_Practic

320 Philosophical Foundations of Health Education
Despite these notable achievements in disease control and prevention, there is
mounting evidence that disparities in health care have grown unacceptably wide in
American society. The disparities between minorities and the white population have
increased in the last decade [1989 – 1999] on virtually every measure of health status
(U.S. Department of Health and Human Services, 1998a). Consequently, the Healthy
People 2010 Objectives (U.S. Department of Health and Human Services, 1998b)
calls for the elimination of health disparities in six major areas — infant mortality, cardiovascular
disease, diabetes, and HIV/AIDS, as well as cancer screening and management
and childhood and adult immunizations. Health education advocacy can play
an important role in eliminating such health disparities (Montes & Johnson, 1998).
Advocacy constitutes the development of coalitions and partnerships, as well as working
with the media, to influence political, regulatory, and environmental policies that
can improve community health. There are numerous examples of health promotion
policy initiatives that have relied on advocacy efforts to influence the tobacco, alcohol,
and environmental issues (Green & Kreuter, 1999). Although there is not extensive
literature on the use of advocacy to reduce health disparities among disadvantaged
populations, Braithwaite and Lythcott (1989) and Thomas (1990) have argued that
community empowerment strategies are critical to health promotion for African
Americans and other minorities.
This paper will first summarize the mounting evidence of disparities in health
status and access to health services across disadvantaged American populations. Next,
we review some of the major contributing factors to these health disparities. We then
highlight selected examples of advocacy approaches that have been conceptualized
and implemented in health education efforts. Finally, we conclude by discussing the role
of advocacy aimed at eliminating the health disparities that persist among the
disadvantaged.
DISPARITIES IN HEALTH STATUS AND ACCESS
TO HEALTH SERVICES
Despite notable progress in achieving many of the national goals and objectives for
the improvement of overall health status, there are persistent disparities in the burden
of illness and death experienced by African Americans, Hispanics and Latinos,
American Indians and Alaskan Natives, and Pacific Islanders. According to the U.S.
Department of Health and Human Services (1998c), these disparities are even greater
when comparisons are made between each racial and ethnic group and the U.S. population
as a whole.
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Infant mortality rates are two and a half times higher for African Americans and
one and a half times higher for Native Americans than for Caucasian Americans.
African American men under 65 years of age suffer from prostate cancer at nearly
twice the rate of Caucasians.