Two issues dominated the times: the Cold War in foreign affairs and the civil rights movement in the domestic arena. In , the Cuban missile crisis made the world collectively hold its breath for 13 days as the Americans and Soviets brokered a stand-down.
Beginning in , the Cold War spawned another problem, as a small country on the other side of the earth, Vietnam, played host to the longest war and the worst foreign quagmire in American history. Then there was the race to the moon, which saw the Soviets take an early lead only to be eclipsed by superior American know-how in Against the backdrop of these foreign affairs issues, which held the fate of the United States and its people in the balance, came a revolution in American race relations, as African Americans stood up en masse and demanded the equality they had been granted on paper in the Reconstruction Amendments nearly a century earlier.
As they and their white liberal allies pushed the envelope of change in the early s, they inspired other, smaller minority groups to emulate their actions. By the end of one decade and the beginning of the next, Hispanics and American Indians had stood up for their rights, as well.
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Despite the notable precursors of the s— Brown v. Board of Education , the Montgomery bus boycott, and the Little Rock school integration crisis—white America was still not really prepared for the deluge of civil rights activity that came in the s.
An unknown error has occurred. Please click the button below to reload the page. The relationship between male and female standardized death rates varies among groups. For both Whites and Blacks, female age-adjusted death rates are a little less than half the age-adjusted rates of males. The differences are smaller for Hispanics, Asians, and American Indians.
Infant mortality is defined as the number of deaths in the first 11 months of life per 1, live births. Infant mortality can be broken down into neonatal mortality rate of deaths in the first 28 days of life per 1, live births and postneonatal mortality the rate of deaths in the 1st through 11th month of life per 1, live births. Deaths in the neonatal period often result from congenital anomalies and problems associated with preg-. During —, 20 states had a census question about Hispanic or ethnic origin, but only these 15 had comparable wording on the origin question and at least 90 percent completion for that question.
Deaths in the postneonatal period more likely result from environmental causes Bertoli et al.
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Particular data problems arise for infant mortality statistics. Babies of mixed ethnicity tend to be more often classified as White at death than at birth, leading to an underestimate of the infant mortality for non-Whites Barringer et al. Second, in , the National Center for Health Statistics changed the way it calculated the race of live births. Since , the race, for all births, is classified as the race of the mother. On a death certificate, the race of a child is not determined by any uniform rules, but by the next of kin or an official local or state recorder. The change in race coding of live births led to significant increases in the rates of infant mortality for racial and ethnic minority groups, especially for American Indians, Japanese, and Hawaiians Hoyert, ; and this change limits our ability to compare rates before and after Despite these additional data limitations, overall trends in infant mortality, as presented in Table 3—12 , reveal dramatic declines in the U.
The decrease results from significant reductions in neonatal mortality MacDorman and Rosenberg, ; Singh and Yu, ; it falls short, however, of declines experienced in other industrialized countries. The slower pace of declines in infant mortality in the United States is largely the result of racial and socioeconomic inequalities in U. Age Adjusted for Both Sexes a.
Age Adjusted for Females a. American Indian a. In , Asians had the lowest infant mortality rates. Hispanics and Whites had the next lowest rates. American Indians had the second highest infant mortality rate, and Blacks had the highest. The low rates for Asians and Hispanics mask the variability within these groups. For neonatal mortality, Blacks have an astonishingly high rate; Puerto Ricans, Whites, and Hawaiians have the next highest rates; and Chinese, Japanese, and Filipinos have the lowest rates.
Cubans have the lowest Hispanic neonatal mortality rate. Postneonatal mortality rates remain especially high for American Indians and Blacks. American Indians have experienced larger decreases in infant mortality than have Whites. Between and , White infant mortality fell by 73 percent while American Indian infant mortality fell by 86 percent. Most of the declines in infant mortality for American Indians occurred between and , and the decline results from reductions in postneonatal mortality.
Black infant mortality rates have declined the least since , by 65 percent. For Blacks, both neonatal and postneonatal mortality-rate declines contributed equally to the overall reduction in infant mortality rates since ; but declines in neonatal mortality rates have not kept pace with that of Whites.
Since the s, the gap between White and Black infant mortality rates has actually widened. Since , Asian infant mortality rates have declined by 32 percent and Hispanic infant mortality rates have declined by 26 percent. Reductions in postneonatal mortality account for the overall attenuation of infant mortality rates for Asians and Hispanics since The reduction in infectious and parasitic diseases largely accounts for the lower death rates and longer life expectancies reported here.
This reduction occurred as a result of progress made in medicine and sanitation, as well as improvements in nutrition and health awareness Zopf, Reductions in infant mortality have been associated with increased and improved prenatal care and better maternity health habits. Employment and higher education and income status are associated with lower mortality for all groups Kitagawa and Hauser, ; Bertoli et al. Also, the concentrated efforts of public health organizations, for the population as a whole and for various racial and ethnic groups, have helped improve health standards for everyone.
The Indian Health Service and tribal health clinics, for example, greatly improved the health conditions of American Indians in areas of infant mortality, tuberculosis, gastrointestinal disease, and accidents Indian Health Service, One of the three broad goals of the Presidential Healthy People Plan included targeted efforts to reduce health disparities for racial and ethnic groups, especially along the lines of infant mortality and certain causes of death Plepys and Klein, ; also see the discussion in Volume II, Chapter Also, because foreign-born members of Asian and Hispanic groups tend to be healthier than their U.
The reason for better immigrant health might be that those Hispanics and Asians able to migrate are healthier than the general homeland populations Barringer et al. Discrepancies between the White and non-White mortality regimes continue to exist, despite advances, for several reasons.
First, socioeconomic differences persist between Whites and non-Whites. Higher death and infant mortality rates, and higher instances of certain causes of disease, are associated with lower education and income levels Kitagawa and Hauser, ; Cramer, ; and non-Whites, with the exception of Asians, have lower education and income levels Harrison and Bennett, Asians have better-than-average socioeconomic status and, con-currently, lower mortality rates.
Second, racial and ethnic groups have lower rates of health insurance coverage and receive lower-quality medical care than do Whites U. General Accounting Office, ; Zopf, Finally, diet and health practices vary by racial and ethnic group and influence certain causes of disease, such as heart disease, stroke, and lung cancer Gardner et al. There is additional discussion of mortality differentials in Volume II, Chapter Few projected estimates are calculated for mortality statistics, but one such projection was made for infant mortality.
Singh and Yu projected neonatal and postneonatal mortality rates for Blacks and Whites through the year Based on their projections, the overall Black-White. These forecasts, however, do not take into account political, social, behavioral, demographic, or medical influences on future mortality changes. Other Healthy People goals include increased screening and management for cancer; reductions in stroke and heart disease mortality; the elimination of disparities in diabetes, especially for Blacks and American Indians; equal access to life-enhancing therapies for low-income HIV-infected persons; and increased access to immunizations for minorities U.
Each of these measures will help eliminate important differences among racial and ethnic groups and break down barriers to increased life chances. These measures could help bring our population one step closer to a convergence in infant mortality and life expectancy. Racial and ethnic minority groups suffer disproportionately from higher mortality rates and, thus, lower life expectancies and unequal chances for survival. Most of the gaps between Whites and non-Whites have narrowed over the years, but continue to be significant.
Especially disturbing is the continued, and increasing, gap between Black and White infant mortality. The United States has experienced a great reduction in the leading causes of death during this century, from suffering and dying primarily from infectious and parasitic diseases to degenerative diseases. Racial and ethnic groups have experienced this reduction in leading cause of death later than Whites, and still suffer more from infectious diseases than do Whites. The leading causes of death differ greatly, depending on age groups, but for both age-specific and overall causes of death, mortality rates are generally higher for Blacks and American Indians.
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Additional difficulties arise for interpreting racial and ethnic mortality statistics because of multiple data problems. Combined, these data problems tend to underestimate the mortalities of non-Whites. Regardless of whether these estimates are lower bounds of the true discrepancies between racial and ethnic groups and Whites, clearly more attention needs to be devoted to the health conditions of minorities.
The United States has witnessed significant demographic shifts in its racial and ethnic composition over the past 50 years, and still greater change is anticipated in the twenty-first century. Historically, Blacks con-.
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Hispanics are expected to surpass Blacks as the largest minority group, and the Asian population is expected to increase more rapidly than any other group. Projected increases in the Hispanic and Asian populations can be partially explained by the influx of immigrants in the past several decades. The regional and metropolitan distribution of different racial and ethnic groups in the United States often reflects patterns of international migration.
Foreign-born immigrants traditionally cluster on the coasts in port-of-entry cities such as Los Angeles, Miami, and New York; however, substantial numbers of the second generation move to inland metropolitan areas. In spite of all this movement, for both internal migrants and immigrants, racial and ethnic minority groups tend to migrate to areas with existing concentrations of coethnics or members of their racial or ethnic group. Another aspect of the growing Hispanic population is fertility rates. Hispanic women have traditionally had much higher fertility rates than Whites and slightly higher rates than Blacks.
In , American Indian women had higher fertility rates than White, Black, and Asian women, for whom the rate was lowest, mostly because American Indian women start childbearing earlier and continue to have children much later than women in other racial and ethnic groups.