Skip Navigation U.S. Department of Health and Human Services www.hhs.gov
Agency for Healthcare Research Quality www.ahrq.gov
Archive print banner
National Healthcare Disparities Report, 2004

This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.

Please go to www.ahrq.gov for current information.

Quality of Health Care

Cancer. Among the elderly, high quality health care includes screening for cancer and cardiovascular risk factors. Of all cancers that can be prevented by screening, colorectal cancer is the most deadly, causing over 55,000 deaths each year. Screening for colorectal cancer with fecal occult blood testing or sigmoidoscopy is an effective means of reducing the incidence of late stage disease and mortality caused by this cancer. The 2003 NHDR showed that while the elderly are more likely to receive colorectal cancer screening than younger age groups, racial, ethnic, and socioeconomic differences exist (NHIS, 2000). This year, more robust estimates from the MCBS are highlighted.

Figure 4.25. Elderly Medicare beneficiaries who reported ever having sigmoidoscopy or colonoscopy by race, ethnicity, and income, 2000

Figure 4.25. Elderly Medicare beneficiaries who reported ever having sigmoidoscopy or colonoscopy by race, ethnicity, and income, 2000. Select Full Text Description [D] for details.

[D] Select for Full Text Description.

Source: Medicare Current Beneficiary Survey, 2000.

Reference population: Medicare beneficiaries age 65 and older living in the community.

  • In 2000, the proportion of elderly Medicare beneficiaries who reported ever having sigmoidoscopy or colonoscopy was lower among those age 85 and older than among those age 65 to 74.
  • Within all age groups, receipt of sigmoidoscopy or colonoscopy was lower among black compared with white elderly and among poor, near poor, and middle income compared with high income elderly (Figure 4.25). In addition, receipt of sigmoidoscopy or colonoscopy was lower among API compared with white elderly and Hispanic compared with non-Hispanic white elderly age 65 to 74 and age 75 to 84.
  • High income elderly of all racial and ethnic groups and middle income whites achieved the HP2010 goal of 50% screened with sigmoidoscopy or colonoscopy while other racial, ethnic, and income groups did not.

Vaccinations. Vaccination of the elderly is an effective strategy for reducing illness and death associated with pneumococcal disease and influenza.

Figure 4.26. Elderly Medicare beneficiaries that ever had pneumonia vaccination by race (top), ethnicity (middle), and income (bottom), 1998-2000

Figure 4.26. Elderly Medicare beneficiaries that ever had pneumonia vaccination by race, 1998-2000. Select Full Text Description [D] for details.

[D] Select for Full Text Description.

Figure 4.26. Elderly Medicare beneficiaries that ever had pneumonia vaccination by ethnicity, 1998-2000. Select Full Text Description [D] for details.

[D] Select for Full Text Description.

Figure 4.26. Elderly Medicare beneficiaries that ever had pneumonia vaccination by income, 1998-2000. Select Full Text Description [D] for details.

[D] Select for Full Text Description.

Source: Medicare Current Beneficiary Survey, 1998-2000.

Reference population: Medicare beneficiaries age 65 or older living in the community.

  • In all 3 years, the proportion of elderly Medicare beneficiaries who had pneumococcal vaccination was lower among black compared with white elderly, among Hispanic compared with non-Hispanic white elderly, and among poor and near poor compared with high income elderly (Figure 4.26).
  • The proportion of elderly Medicare beneficiaries who had pneumococcal vaccination was also lower among AI/AN elderly compared with white elderly in 2000.
  • Between 1998 and 2000, proportions with pneumococcal vaccination improved among white and black elderly, non-Hispanic white elderly, and all income groups.

Racial and ethnic minorities are disproportionately poor. To distinguish the effects of race, ethnicity, and income on health care utilization, measures are presented by income level.

Figure 4.27. Elderly Medicare beneficiaries that ever had pneumonia vaccination by race (top) and ethnicity (bottom) stratified by income, 2000

Figure 4.27. Elderly Medicare beneficiaries that ever had pneumonia vaccination by race, stratified by income, 2000. Select Full Text Description [D] for details.

[D] Select for Full Text Description.

Figure 4.27. Elderly Medicare beneficiaries that ever had pneumonia vaccination by ethnicity, stratified by income, 2000. Select Full Text Description [D] for details.

[D] Select for Full Text Description.

Source: Medicare Current Beneficiary Survey, 2000.

Reference population: Medicare beneficiaries age 65 or older living in the community.

  • Income explains some but not all of the differences in health care among the elderly by race and ethnicity.
  • Black-white differences in pneumonia vaccination tend to attenuate among people with high incomes. However, they persist among the poor and near poor (Figure 4.27).
  • Hispanic-non-Hispanic white differences in pneumonia vaccination are present at all income levels.
  • No group achieved the HP2010 goal of 90% of elderly vaccinated against pneumococcal disease.

 

 

The information on this page is archived and provided for reference purposes only.

 

AHRQ Advancing Excellence in Health Care