Excerpt from Astho Bilingual Health Initiative Report and Recommendations: State Health Agency Strategies to Develop Linguistically Relevant Public Health Systems; July 1992

In 1984, the Secretary's Task Force on Black and Minority Health initiated the first comprehensive analysis by the Department of Health and Human Services of the disparity in deaths and illnesses experienced by racial and ethnic minority populations in the United States. Since that time, a concerted effort at the federal, state, local, and community levels has been undertaken to address the needs of minority populations in Order to increase access to health services and to decrease health disparities. In 1990 the Department of Health and Human Services issued its report, Healthy People 2000: National Health Promotion and Disease Prevention Objectives, listing over 100 objectives targeting the needs of growing racial and ethnic minority populations. The Healthy People report has become a partial blueprint for planning and policy development at the state and national level, as states have developed their own priority objectives and strategized ways to improve the health of state residents.

Lack of standardized data obscures health disparities and the effect of cultural and linguistic barriers to health care for ethnic groups such as Hispanics, Asians and Pacific Islanders, Native Americans, Alaskan Natives, and Caribbean Islanders. Although race-specific data has been compiled on health indicators for whites and blacks, little standardized data is available on individual ethnic populations. Lack of data is often attributed to the small size of ethnic and racial populations, and to the difficulty in designing appropriate health status and health needs assessment instruments. Where information is available, the disproportionately poor health status of refugees, new immigrants, migrant farm workers, and isolated groups of non-english speaking people has been documented through intermittent public and private health assessments.

Many clear differences in the health status of ethnic groups have been identified. For example, the diverse population of Hispanics in the United States, mainly consisting of people of Mexican, Puerto Rican, Cuban, and Central and South American descent, represents percent of the country's population. In aids cases reported in 1989, however, Hispanics represented 16 percent of people with aids. Hispanics also have a higher risk for non-insulin dependent diabetes. In Texas, the rate of Hispanic morbidity from diabetes compared to that of the non-hispanic white population was more than 2 to 1. One in 8 Mexican Americans will develop diabetes, compared to one in 15 for non-hispanic whites. Disparities in health status also exist between Hispanic subgroups. Hispanics overall have a percent risk of low birth weight babies, and non-hispanic whites have a percent risk level; the rate for Puerto Ricans is much higher than average percent), but the rate for Cubans is lower percent).

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