Evaluating Chicago's success in reaching the Healthy People 2000 goal of reducing health disparities.
OBJECTIVE
This study was designed to assess Chicago's progress from 1980 to 1998 in addressing the Healthy People 2000 goal of reducing health disparities.


METHODS
Chicago vital statistics and surveillance data were used to calculate black:white rate ratios of mortality and morbidity for 1980-1998. Mortality and morbidity rate ratios were also used to compare people living in areas with the lowest median household income with those living in the highest for 1979-1981, 1991-1993, and 1996-1998. The health measures included mortality associated with leading causes of death; all-cause mortality, incidence rates for two communicable diseases; and two birth outcomes.


RESULTS
Both black:white and low-income:high-income rate ratios monotonically increased for virtually all measures of mortality and morbidity. Almost all of the rate ratios and linear trends were statistically significant. From 1980 to 1998, the black:white rate ratio for all-cause mortality increased by 57% to 2.03. From 1979-1981 to 1996-1998, the low-income:high-income rate ratio for all-cause mortality increased by 56% to 2.68.


CONCLUSIONS
These findings provide clear evidence that disparities in health did not decrease in Chicago. Instead, racial and economic disparities increased for almost all measures of mortality and morbidity used in this study. The fact that the Healthy People 2000 campaign to reduce and then eliminate health disparities was not effective must serve as a stimulus for improved strategies.
Silva
A
A
Sinai Urban Health Institute, Mt. Sinai Hospital, Sinai Health System, Chicago, IL 60608, USA. sila@sinai.org
Whitman
S
S
Margellos
H
H
Ansell
D
D
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D002423:Cause of Death; D002641:Chicago / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006292:Health Priorities; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D009017:Morbidity / Q000639:trends*; D009026:Mortality / Q000639:trends*; D011203:Poverty / Q000208:ethnology; D011204:Poverty Areas; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology; D011635:Public Health Administration; D012959:Socioeconomic Factors; D014504:Urban Health; D044465:White People / Q000706:statistics & numerical data*