Summarizing Social Disparities in Health (original) (raw)
Related papers
Measuring health disparities: a comparison of absolute and relative disparities
PeerJ, 2015
Monitoring national trends in disparities in different diseases could provide measures to evaluate the impact of intervention programs designed to reduce health disparities. In the US, most of the reports that track health disparities provided either relative or absolute disparities or both. However, these two measures of disparities are not only different in scale and magnitude but also the temporal changes in the magnitudes of these measures can occur in opposite directions. The trends for absolute disparity and relative disparity could move in opposite directions when the prevalence of disease in the two populations being compared either increase or decline simultaneously. If the absolute disparity increases but relative disparity declines for consecutive time periods, the absolute disparity increases but relative disparity declines for the combined time periods even with a larger increase in absolute disparity during the combined time periods. Based on random increases or decrea...
Understanding health disparities
Journal of Perinatology, 2018
Research suggests that health disparities in the United States are often associated with an individual's race and ethnicity, gender, income level, sexual orientation, or geographic location. Of these factors, the literature primarily focuses on racial and ethnic differences. It is well documented that minority populationsgenerally classified as African Americans, Native Americans, Asian/Pacific Islanders, and Hispanics-have more chronic diseases, higher mortality, and poorer health outcomes than individuals classified as white. a Nationally, the commitment to understanding and eliminating racial and ethnic health disparities is strong. The Healthy People 2010 initiative, a set of health promotion and disease prevention objectives for the nation, aims to eliminate health disparities by the year 2010. Healthy People 2010 has led to a number of federal programs designed to support this goal through data collection and research. The U.S. Department of Health and Human Services (HHS) and its agencies spearhead these efforts. HHS agencies with prominent roles include the Centers for Disease Control and Prevention (CDC), the Office for Civil Rights, the Centers for Medicare & Medicaid Services (CMS), the National Institutes of Health (NIH), and the Health Resources and Services Administration (HRSA). In 1999, as part of the Healthcare Research and Quality Act, Congress directed the Agency for Healthcare Research and Quality, a division of HHS, to develop an annual National Healthcare Disparities Report to track "prevailing disparities in health care delivery as they relate to racial factors and socioeconomic factors in priority populations." Thirty-four states, including Ohio, have a designated governmental entity addressing minority health. Ohio's Commission on Minority Health, established in 1987, was the first entity of its kind in the nation. Recently, the commission won a federal contract to create the National Association of State Offices of Minority Health. The purpose of this background paper is to create a common understanding on the issue of health disparities. The paper will define and describe current health disparities among racial and ethnic groups as well as present a framework for examining the intricate web of factors that can contribute to disparities. It will then offer potential policy solutions for addressing the issue of health disparities, as well as the challenges associated with each. Health Policy Institute of Ohio 3 Healthy People 2010 defines disparities in health as the "unequal burden in disease morbidity and mortality rates experienced by ethnic/racial groups as compared to the dominant group." 1 The Institute of Medicine's 2002 report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare ("the IOM Report") defines disparities in health care as "differences in the quality of health care that are not due to access-related factors or clinical needs, preferences or appropriateness of intervention." 2 The Health Resources and Services Administration, a key player in the national effort to eliminate disparities in health, defines health disparities as "population-specific differences in the presence of disease, health outcomes, or access to health care." What causes health disparities? Why are minority populations overburdened with disease and poor health outcomes? Are there promising solutions to this complex problem? A review of the research literature suggests that a multitude of complex factors contributes to health disparities, but little is known about the relative importance of these factors. In the 1985 Health and Human Services' "Report of the Secretary's Task Force on Black and Minority Health," health is said to be "influenced by the interaction of physiological, cultural, psychological, and societal factors that are poorly understood for the general population and even less so for minorities." 3 In short, it is challenging for social scientists to find ways to determine if, how, and to what extent each of these factors is related to health disparities experienced by minorities. Why is there such a strong national commitment to eliminate health disparities? With an increasingly diverse population, the health of our nation depends on our ability to keep minority populations healthy. According to Census 2000 results, minorities represent approximately 25 percent of the nation's population. Hispanics-now the nation's largest minority group-represent 12.5 percent of the total population, with 11 percent of the United States population citing Spanish as their primary language. 4 Hispanics and Asians account for more than 50 percent of the nation's population growth; between 2000 and 2050, the Hispanic b and Asian populations will more than triple, with Hispanics representing nearly a quarter of the total population and Asians representing 8 percent. 5 In Ohio, whites represent about 85 percent of the population and minorities represent about 15 percent [African American (11.5 percent), two or more races (1.4 percent), Asian (1.2 percent), other (0.8 percent), and Native American (0.2 percent)]. 6 The Hispanic population in Ohio grew 36 percent between 1990 and 2000, and now accounts for 1.9 percent of the state's total population. 7 b According to the U.S. Census Bureau, "Race and Hispanic origin are two separate concepts in the federal statistical system. People who are Hispanic may be of any race. People in each race group may be either Hispanic or Not Hispanic. Each person has two attributes, their race (or races) and whether or not they are Hispanic." U.S. Census Bureau, "U.S. Census Bureau Guidance on the Presentation and Comparison of Race and Hispanic Origin Data" (2003).
Harmonizing Health Disparities Measurement
American Journal of Public Health
Recommendation 3: Develop a common set of "sentinel," or early warning, indicators for health disparities. Recommendation 4: Establish a standard set of criteria for using population characteristics with accompanying rationales that support their inclusion in health disparities research. Recommendation 5: For widely used population characteristics, identify standard population groups and establish a standard approach to define reference groups. Recommendation 6: Promote sharing of analytical data sets and codes to support scientific reproduction as well as comparison among various health outcome indicators and health disparity populations. Recommendation 7: Establish guidelines regarding the core considerations for choosing a health disparity measure. Recommendation 8: State explicitly the value judgments endorsed by the choice of a measure in each health disparity study and develop a culture of explicit discussion.
Measuring Health Disparities and Health Inequities
Quality Management in Health Care, 2012
Measuring health disparities is a challenging and at times a difficult proposition. It is generally accepted that at minimum, collecting, analyzing, reporting, and applying data through tailored and targeted interventions responsive to issues regarding race, ethnicity, and preferred language are essential for identifying, monitoring, and, ultimately, eliminating health disparities. Key to eliminating these disparities is determining whether the care and services being provided are resulting in vastly different experiences for some patients. Health care institutions and providers often convince themselves that collecting these data is a time-consuming, costly, and arduous endeavor. However, if patient information on Race, Ethnicity, Gender, Age, and preferred Language (REGAL) is currently being collected, one has the basic elements to effectively measure disparities across a host of clinical and nonclinical indicators. In formulating comparisons among targeted populations in areas such as access to health care, health care quality, health outcomes, prevention, early detection, treatment, and morbidity and mortality rates, it is critical to frame part of the discussion around collecting, analyzing, reporting, and applying REGAL data, including future expansion of measures and indicators. The Health Disparities REGAL Data Dashboard is a useful tool for health care institutions and providers and can provide an innovative approach to measuring health disparities.
Compiling The Evidence: The National Healthcare Disparities Reports
Health Affairs, 2005
Disparities in health care have been described extensively in the literature. The next step in resolving this national problem is to develop the necessary infrastructure for monitoring and tracking disparities. The congressionally mandated National Healthcare Disparities Report begins to build this infrastructure. The 2003 report addressed many of the methodological challenges inherent in measuring disparities. The recently released 2004 report continues the process by summarizing the status of U.S. health care disparities and beginning to track changes over time. Both reports emphasize the need to integrate activities to reduce disparities and to improve the quality of health care.
American journal of public health, 2014
Historically, researchers and policy planners have selected a single indicator to measure trends in social inequalities. A more rigorous approach is to review the literature and data, select appropriate inequality measures to address the research question, compute results from various indices, and graphically compare resulting trends. The Health Disparities Calculator (HD*Calc, version 1.2.4; National Cancer Institute, Bethesda, MD) computes results from different indices and graphically displays them, making an arduous task easier, more transparent, and more accessible.