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National Healthcare Disparities Report, 2005

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Disparities Still Exist

Consistent with extensive research and findings in previous NHDRs, the 2005 report finds that disparitiesiii related to race, ethnicity, and socioeconomic statusiv still pervade the American health care system. While varying in magnitude by condition and population, disparities are observed in almost all aspects of health care, including:

  • Across all dimensions of quality of health care including effectiveness, patient safety, timeliness, and patient centeredness.
  • Across all dimensions of access to care including facilitators and barriers to care and health care utilization.
  • Across many levels and types of care including preventive care, treatment of acute conditions, and management of chronic disease.
  • Across many clinical conditions including cancer, diabetes, end stage renal disease, heart disease, HIV disease, mental health and substance abuse, and respiratory diseases.
  • Across many care settings including primary care, dental care, home health care, emergency departments, hospitals, and nursing homes.
  • Within many subpopulations including women, children, elderly, residents of rural areas, and individuals with disabilities and other special health care needs.

To quantify the prevalence of disparities across the core report measures tracked in the 2005 report, racial, ethnic, and socioeconomic groups are compared with an appropriate comparison groupv for each core report measure. Each group could receive care that is poorer than, about the same as, or better than the comparison group.

Figure H.1. Measures of quality for which members of selected groups experienced better, same, or poorer quality of care compared with reference group

Figure H.1 .Measures of quality for which members of selected groups experienced better, same, or poorer quality of care compared with reference group

[D] Select for Full Text Description.

Better: = Population received better quality of care than the comparison group.

Same: = Population and comparison group received about the same quality of care.

Worse: = Population received poorer quality of care than the comparison group.

Key: AI/AN = American Indian or Alaska Native.

Note: "Asian" includes "Asian or Pacific Islander" when information is not collected separately for each group. Data on all measures are not available for all groups so totals differ among groups. Data presented are the most recent data available. Totals may not add to 100% due to rounding.

For sizable proportions of measures, minorities and the poor receive lower quality care. Of core report measures of quality, for example:

  • Together, Blacks and American Indians and Alaska Natives (AI/ANs) received poorer quality care than Whites for about 40% (20/46 and 8/21, respectively) of core report measures (Figure H.1). Blacks received better quality care than Whites for 11% (5/46) of measures, and AI/ANs received better quality care for 14% (3/21) of measures.
  • Asians received poorer quality care than Whites for 21% (7/32) of core report measures and better quality care for 38% (12/32) of measures.
  • Hispanics received poorer quality of care than non-Hispanic Whites for over half of core report measures (20/38) and better quality care for 16% (6/38) of measures.
  • Poor peoplevi received lower quality of care than high income people for 85% (11/13) of core report measures and better quality care for 8% (1/13) of measures.

Figure H.2. Measures of access for which members of selected groups experienced better, same, or worse access to care compared with reference group

Figure H.2. Measures of access for which members of selected groups experienced better, same, or worse access to care compared with reference group.

[D] Select for Full Text Description.

Better: = Population had better access to care than the comparison group.

Same: = Population and comparison group had about the same access to care.

Worse: = Population had worse access to care than the comparison group.

Key: AI/AN = American Indian or Alaska Native.

Note: "Asian" includes "Asian or Pacific Islander" when information is not collected separately for each group. Data on all measures are not available for all groups, so totals differ among groups. Data presented are the most recent data available. Totals may not add to 100% due to rounding.

For many measures, minorities and the poor have worse access to care. Of core report measures of access:

  • Blacks and AI/ANs had worse access to care than Whites for half (4/8 and 3/6, respectively) of core report measures (Figure H.2) and better access to care for no measures.
  • Asians had worse access to care than Whites for 43% (3/7) of core report measures and better access for 14% (1/7) of measures.
  • Hispanics had worse access to care than non-Hispanic Whites for 88% (7/8) of core report measures.
  • Poor people had worse access to care than high income people for all 8 core report measures.

iii Consistent with Healthy People 2010, the NHDR defines disparities as any differences among populations. In addition, all disparities discussed in the NHDR meet criteria based on statistical significance and size of difference described in Chapter 1, Introduction and Methods.
iv Income and education are the primary measures of socioeconomic status used in the report.
v For all measures, Blacks, Asians, and American Indians and Alaska Natives are compared with Whites; Hispanics are compared with non-Hispanic Whites; and poor individuals are compared with high income individuals.
vi "Poor" is defined as having family income less than 100% of the Federal poverty level and "high income" is defined as having family income 400% or more of the Federal poverty level.


 

 

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