What Ethnicity Has the Most Anemia? Understanding Disparities

November 21, 2025 •

4 min read

According to the CDC, during 2021–2023, Black non-Hispanic females had the highest prevalence of anemia in the United States at 31.4%, significantly higher than any other race or Hispanic-origin group. This marked disparity is a key indicator when exploring what ethnicity has the most anemia, revealing how a combination of genetic and social factors contribute to unequal health outcomes.

Quick Summary

Anemia prevalence varies significantly across different ethnic groups due to a combination of genetic risk and social determinants of health. Black Americans and individuals of Mediterranean, Southeast Asian, and Middle Eastern descent have higher rates, often linked to inherited conditions like sickle cell disease and thalassemia, compounded by socioeconomic factors and unequal access to healthcare.

Key Points

Prevalence in the U.S.: Recent CDC data indicates that Black non-Hispanic females have the highest anemia prevalence in the United States, followed by other ethnic groups like Hispanic and Asian females.
Genetic Factors: Inherited conditions like Sickle Cell Disease (SCD) and Thalassemia contribute significantly to higher anemia rates in specific populations. SCD is most common in those of African, Mediterranean, and Indian descent, while Thalassemia is prevalent in Mediterranean, Southeast Asian, and African populations.
Protective Evolutionary Traits: The genetic predispositions for SCD and Thalassemia are believed to be evolutionary adaptations that provided a survival advantage against malaria in high-prevalence regions.
Social Determinants of Health: Socioeconomic factors like poverty, inadequate nutrition, and unequal access to healthcare exacerbate anemia rates in marginalized ethnic groups.
Global Burden: On a global scale, the highest burden of anemia is found in the WHO regions of Africa and South-East Asia, particularly affecting children and women.
Pregnancy Risk: Pregnant individuals from certain ethnic minority groups, such as Black Americans and specific groups in Nepal, face a higher risk of anemia, which can contribute to severe maternal morbidity.
Multifactorial Issue: Ethnic disparities in anemia are not caused by race but by a complex interplay of genetic factors, environmental influences, and social inequities.

Unpacking Ethnic Disparities in Anemia Prevalence

While anemia is a global health issue, its prevalence is not evenly distributed across ethnic groups. Data highlights significant disparities in the United States, pointing to complex genetic and environmental factors that influence rates worldwide. Understanding these differences, including genetic predispositions and social determinants of health, is crucial for targeted public health interventions.

United States Data Highlights Highest Prevalence

National Health and Nutrition Examination Survey data from 2021–2023 shows clear ethnic differences in anemia prevalence in the U.S.. Black non-Hispanic females had the highest prevalence at 31.4%, while Black non-Hispanic males also had the highest rates among males at 10.8%. Hispanic females (15.0%) and Asian females (15.9%) also experienced higher rates than White females (8.3%). These statistics indicate that Black non-Hispanic individuals, particularly women, are disproportionately affected in the U.S., a result of complex interactions between genetics and environment.

The Role of Inherited Anemias: Sickle Cell Disease and Thalassemia

Inherited anemias like Sickle Cell Disease (SCD) and Thalassemia are more common in specific ethnic populations, partly explaining observed disparities. These genetic traits are thought to be protective evolutionary responses to malaria in certain regions. SCD, characterized by sickle-shaped red blood cells, is most prevalent in people of African ancestry globally and among African Americans in the U.S., as well as those of Mediterranean, Middle Eastern, and Indian descent. Thalassemia, a disorder affecting hemoglobin production, is prevalent in the Mediterranean region (beta-thalassemia, or "Mediterranean anemia"), the Middle East, South Asia, Southeast Asia, and in populations of African descent.

Social and Environmental Factors Drive Disparities

Beyond genetics, social determinants of health, such as income, nutrition, and healthcare access, significantly impact anemia rates. A CDC data brief highlighted that the lowest income group had more than double the anemia prevalence of the highest income group. Inadequate diet and food insecurity contribute to iron deficiency anemia, the most common type globally. Unequal access to quality prenatal care and preventative screening also increases anemia risk, particularly for pregnant individuals in underprivileged ethnic groups.

Global Prevalence of Anemia

Globally, Africa and South-East Asia have the highest burden of anemia, impacting children and women of reproductive age most significantly. The WHO estimated that in 2019, 37% of pregnant women and 30% of women of reproductive age worldwide were affected. The combination of genetic conditions and widespread issues like nutritional deficiencies and parasitic infections contributes to these high rates.

Comparative Analysis of Anemia Risk Factors by Ethnicity


Ethnic Group	Primary Anemia Risk Factors	Genetic Conditions	Social Determinants of Health	Data Context
Black/African American	High prevalence of inherited anemias (e.g., Sickle Cell), chronic disease, and socioeconomic factors.	Sickle Cell Disease and Thalassemia.	Significant impact from socioeconomic status, access to nutritious food, and healthcare access.	U.S. and global data show high prevalence, especially among women.
Mediterranean	Genetic predisposition to thalassemia, diet, and history of malaria.	Beta-thalassemia, Hemoglobin S/beta-thalassemia.	Varies by socioeconomic status and healthcare access in different countries.	High carrier rates for thalassemia; prevalence influenced by historical migration.
South Asian	Thalassemia, iron deficiency, malnutrition, and infectious diseases.	Thalassemia (e.g., β-thalassemia major is common in India).	High prevalence in marginalized groups, influenced by socioeconomic indicators.	Regional studies show uneven distribution, with high rates in countries like India.
Southeast Asian	Thalassemia, iron deficiency, and genetic variants.	Both Alpha and Beta Thalassemia, Hemoglobin E/beta-thalassemia.	Socioeconomic status and access to care influence outcomes.	Regional carrier frequencies vary significantly, historically linked to malaria.
Hispanic	Iron deficiency (especially in women), genetic factors, and socioeconomic status.	Sickle Cell Trait and Thalassemia found in some populations.	Inadequate dietary intake, food insecurity, and disparities in access to care.	High prevalence among women in the U.S. and other regions.
White (Non-Hispanic)	Generally lower risk compared to other groups, but still affected by chronic disease and nutritional issues.	Lower prevalence of SCD and Thalassemia compared to high-risk groups.	Factors like age and chronic disease are significant, alongside diet and income.	U.S. data shows significantly lower overall prevalence.

Conclusion

The question of what ethnicity has the most anemia highlights a complex interplay of genetic inheritance and social inequality. While Black non-Hispanic individuals in the U.S. show the highest prevalence according to recent CDC data, this reflects the intersection of genetic risk, like for sickle cell disease, with significant social determinants of health. Disparities are also pronounced globally, especially in regions with a history of malaria, where inherited anemias such as thalassemia are common. Addressing these inequities requires a multi-faceted approach targeting social factors and providing tailored care for genetically vulnerable populations. The World Health Organization (WHO) offers extensive resources on global anemia prevalence and prevention.

This article provides general information and should not be considered a substitute for professional medical advice. Always consult with a healthcare provider for any health concerns or before making decisions related to your treatment.

Frequently Asked Questions

Genetic blood disorders like sickle cell disease and thalassemia are more common in ethnic populations whose ancestors lived in regions where malaria was endemic. The inherited gene traits offered a survival advantage against the malaria parasite, leading to their persistence in these populations.

The most common form of anemia globally is iron-deficiency anemia, which is caused by a lack of iron. While often linked to poor diet and nutrition, it can also result from chronic blood loss and inadequate iron absorption.

Social determinants of health, including lower household income, food insecurity, and disparities in healthcare access, are significant contributors. For example, lower income can limit access to iron-rich foods, and lack of adequate prenatal care can worsen anemia during pregnancy.

Studies consistently show that anemia prevalence is higher in females than in males across various ethnic groups. This is often due to iron requirements related to menstruation and pregnancy.

No. While some groups have higher rates of genetic anemias, ethnic disparities are influenced by a combination of factors. A CDC study showed that anemia rates in the lowest income group were more than double those in the highest, indicating that social and economic factors play a major role.

Anemia during pregnancy poses risks for both the mother and fetus. Studies have shown higher rates of antepartum anemia among Black and Hispanic pregnant patients in the U.S. compared to White patients, and these disparities are linked to poorer maternal outcomes.

Addressing these disparities requires a multi-pronged approach, including better nutritional education, improving access to healthcare and targeted screening, and tackling underlying socioeconomic inequities that contribute to health inequalities. For inherited anemias, genetic counseling and early intervention are key.