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Racial and ethnic minorities often receive inferior quality of care compared with whites, even after controlling for insurance status and socioeconomic status. The Agency for Healthcare Research and Quality has supported efforts to identify and ameliorate racial and ethnic disparities in care since the Agency's inception in 1989. In a recent article, Carolyn M. Clancy, M.D., Director of the Agency, and her AHRQ colleagues, Daniel B. Stryer, M.D., and Robin M. Weinick, Ph.D., summarize AHRQ initiatives in this area.
AHRQ-supported work documenting care disparities has revealed, for example, that women of Asian, African, and Hispanic descent wait more than twice as long as white women between having an abnormal screening mammogram and receiving followup testing to diagnose breast cancer. Other AHRQ-supported research clarifies some of the underlying causes of disparities. For instance, Hispanics with diabetes often face economic barriers to treatment and are reluctant to place their own medical needs over those of family members.
Under a 5-year, $45-million initiative, AHRQ is supporting nine Excellence Centers to Eliminate Ethnic/Racial Disparities (EXCEED) across the country. The themes of the EXCEED projects include communication, cultural competence, Native American elders, and the interaction of the patient, the provider, and the health care system.
Three AHRQ-sponsored databases and tools—the Healthcare Cost and Utilization Project (HCUP), the Medical Expenditure Panel Survey (MEPS), and the Consumer Assessment of Health Plans Study®—provide the basis for a wide variety of research on racial and ethnic disparities in care. For example, research using HCUP data found that Hispanics have higher rates of inpatient noninvasive diagnostic testing for cerebrovascular disease but lower rates of invasive testing and therapeutic procedures.
AHRQ also supports the training and development of minority researchers and those interested in minority health, for example, through the National Research Service Award program, and the Minority Research Infrastructure Support Program. The Agency also funds numerous Practice-Based Research Networks and Translating Research into Practice projects that are related to disparities.
See "Reducing racial and ethnic disparities in health care," by Drs. Stryer, Weinick and Clancy, in the October 2002 Health Services Research 37(5), pp. xv-xxvi.
Reprints (AHRQ Publication No. 03-R009) are available from the AHRQ Publications Clearinghouse.
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