1. The table below provides infant mortality rates (per 1,000 live births) between African-Americans and non-Hispanic Caucasians in the year 2015 overall as well as stratified according to a variety of demographic (non-race) and care-related factors that are hypothesized to impact those rates:
| Factor | African Americans (IMR) | Non-Hispanic Caucasians (IMR) |
| Total | 13.5 | 5.7 |
| Child Birthweight | ||
| Very low (<1500g) | 266.9 | 232.7 |
| Low (1500-2499g) | 15.8 | 16.0 |
| Normal (>2500g) | 3.9 | 2.2 |
| Age of Mother | ||
| <20 years | 13.8 | 8.5 |
| 20-24 years | 13.1 | 6.2 |
| 25-29 years | 13.1 | 5.1 |
| 30-34 years | 13.8 | 4.7 |
| 35–39 years | 14.5 | 5.4 |
| >40 years | 15.1 | 7.0 |
| Marital Status | ||
| Married | 11.5 | 4.9 |
| Unmarried | 14.4 | 7.8 |
| Prenatal Care Status | ||
| Yes (had prenatal care) | 12.2 | 5.1 |
| No (no prenatal care) | 50.0 | 25.7 |
| Maternal Smoking Status | ||
| Smoker | 19.8 | 10.7 |
| Non-smoker | 12.7 | 6.5 |
Discussion Questions
A. Identify the health outcome(s) and health determinant(s) from the above table.
B. Among the health determinants listed, which ones are modifiable by health policy and which ones are not modifiable by health policy?
C. What is the association that exists between each of the health determinants and health outcome(s) based on the data in the table?
D. What population health policies / intervention(s) would you recommend, based on the data in the table, that would have the greatest impact on reducing IMR overall and/or addressing the disparity in IMR that exists between African-Americans and non-Hispanic Caucasians?
2. Differences in disease rates across races and ethnicities can provide insights into the etiology of diseases as well as provide focus for targeted prevention interventions (primary, secondary, tertiary). The following tables provide information on the prevalence (%) of diabetes in 2011 by race, gender and age (Table 1) and the prevalence (%) of four major diabetes risk factors by race and gender (Table 2). Use this information to answer the questions that follow.
Table 1 – % of population with diabetes, by age/race/gender
| Age | 0-44 | 45-64 | 65-74 | 75+ | Total | Age-adjusted |
| White Males | 1.5 | 12.3 | 22.8 | 21.7 | 7.0 | 6.5 |
| Black Males | 2.5 | 17.6 | 30.7 | 38.1 | 8.2 | 9.9 |
| Hispanic Males | 1.87 | 17.1 | 31.1 | 32.5 | 5.8 | 9.0 |
| White females | 1.5 | 10.0 | 18.4 | 16.6 | 6.3 | 5.4 |
| Black females | 2.4 | 17.1 | 31.2 | 25.9 | 8.7 | 9.0 |
| Hispanic females | 1.7 | 18.7 | 32.6 | 32.3 | 6.8 | 9.3 |
Table 2 – % of population with diabetes risk factors, by race and gender
| Risk Factor | Obesity Age 20+ | Hypertension Age 20+ | Physical Activity Age 18+ | High Cholesterol Age 20+ |
| White Males | 34.0 | 31.2 | 53.7 | 12.1 |
| Black Males | 37.3 | 39.3 | 46.7 | 10.4 |
| Hispanic Males | 38.0 | 28.6 | 44.2 | 15.1 |
| White Females | 32.4 | 28.4 | 46.9 | 15.5 |
| Black Females | 57.2 | 44.0 | 34.3 | 11.5 |
| Hispanic Females | 42.4 | 27.2 | 35.2 | 13.5 |
- How does the prevalence of diabetes vary with age?
- How does the prevalence of diabetes vary based on sex (male vs. female)?
- How does the prevalence of diabetes vary based on ethnicity (white vs. black vs. Hispanic)?
- Based on table 2 results, which of the four risk factors – obesity, hypertension, physical activity, and/or high cholesterol – helps explain the variations in diabetes prevalence rates from table 1?
- Based on the results from Tables 1 and 2, identify two or three prevention strategies that could be implemented to address one or more risk factors for diabetes in one or more of the racial/ethnic and/or gender groups.
3. Identify one example of a primary, secondary, and tertiary prevention strategy (3 total) that could be utilized to positively impact each of the following population health metrics (i.e. to reduce the rates of morbidity and mortality):
- Morbidity/mortality from automobile accidents
- Morbidity/mortality from obesity
- Morbidity/mortality from COVID-19 infection
- Morbidity/mortality from acute stroke
