Tobacco and Health Disparities: Overview and Scientific Evidence

Health disparities in racial and ethnic groups in the U.S. are strongly associated with variations in tobacco use and accessibility as well as the quality of health care. Each year minorities in this country experience at least 60,000 excess deaths (deaths beyond what would be expected if they had the same sex and age-adjusted rates as the white population). Differences across groups can range up to 10 or more years in life expectancy or 20 or more years of limitations on healthy normal functioning. There is an increasing body of scientific evidence indicating that health disparities among racial/ ethnic groups in the U.S. are strongly associated with variations in tobacco use as well as differences in the quality and accessibility of prevention and treatment. This paper will focus on (1) what is known about health disparities related to tobacco use, (2) what the differences are in smoking patterns that may contribute to health disparities, (3) other factors that help to account for health disparities, and (4) suggestions for smoking prevention and cessation efforts specific to diverse populations. These findings help in conceptualizing the problem of tobacco related health disparities and exploring how to proceed in addressing the problem. It is important to note that the causes and cures of health disparities in the United States must be understood in the larger context of economic disparities and racism as well as variations in cultural practices and biological risk factors that are known to influence various epidemiological patterns. Analysis of this larger context has led to recommendations for a community change approach to reducing health disparities and for recognition of existing strengths in minority communities when developing health policies. A recent Institute of Medicine (2002) report concludes quite forcefully, “...differences in treating heart disease, cancer,