Chapter 2. Quality of Health Care (continued, 5)

National Healthcare Disparities Report, 2009

Summary Tables

Table 2.1a. Racial and Ethnic Differences in Effectiveness of Care

Core Report Measure	Racial Differenceⁱ					Ethnic Differenceⁱⁱ
Core Report Measure	Black	Asian	NHOPI	AI/AN	More than 1 Race	Hispanic
Cancer
Women age 40 and over who reported they had a mammogram within the past 2 yearsⁱⁱⁱ	=	↓		=	=	↓
Breast cancer incidence per 100,000 women age 40 and over diagnosed at advanced stage^iv	↓	↑		↑		↑
Breast cancer deaths per 100,000 female population per year	↓	↑		↑		↑
Adults age 50 and over who received a sigmoidoscopy, colonoscopy, or proctoscopy or fecal occult blood test in the last 2 yearsⁱⁱⁱ	↓	↓		↓	=	↓
Colorectal cancer diagnosed at advanced stage^iv	↓	↑		↑		↑
Colorectal cancer deaths per 100,000 population per year^v	↓	↑		↑		↓
Diabetes
Composite: Adults with diabetes who had hemoglobin A1c measurement, dilated eye exam, and foot exam in the calender year^vi	=					↓
End Stage Renal Disease
Adult hemodialysis patients with adequate dialysis^vii	=	↑		↑		↑
Dialysis patients under age 70 who were registered on a waiting list for transplantation^viii	=	↑		=		=

ⁱ Compared with Whites.
ⁱⁱ Compared with non-Hispanic Whites.
ⁱⁱⁱ Source: National Health Interview Survey, 2005.
^iv Source: Surveillance, Epidemiology, and End Results Program, 2006. This source does not provide rate estimates for Asians and NHOPIs separately but in aggregate as Asian and Pacific Islander. This source did not collect information for More than 1 Race.
^v Source: National Vital Statistics System-Mortality, 2006. This source did not collect information on Asians and NHOPIs separately but in aggregate as Asian and Pacific Islander. This source did not collect information for More than 1 Race.
^vi Source: Medical Expenditure Panel Survey, 2005.
^vii Source: CMS End Stage Renal Disease Clinical Performance Measures Project, 2007.
^viii U.S. Renal Data System, 2005. This source did not collect information on Asians and NHOPIs separately but in aggregate as Asian and Pacific Islander. This source did not collect information for More than 1 Race.
Key: NHOPI=Native Hawaiian or Other Pacific Islander; AI/AN=American Indian or Alaska Native.

Table 2.1a. Racial and Ethnic Differences in Effectiveness of Care (continued)

Core Report Measure	Racial Differenceⁱ					Ethnic Differenceⁱⁱ
Core Report Measure	Black	Asian	NHOPI	AI/AN	More than 1 Race	Hispanic
Heart Disease
Composite: Hospital patients with heart attack who received recommended hospital careⁱⁱⁱ	=	=		=		↓
Deaths per 1,000 adult hospital admissions with acute myocardial infarction^iv	↑	↓				=
Composite: Hospital patients with heart failure who received recommended hospital careⁱⁱⁱ	↑	=		↓		↓

ⁱ Compared with Whites.
ⁱⁱ Compared with non-Hispanic Whites.
ⁱⁱⁱ Source: CMS Quality Improvement Organization Program, 2007. This source categorizes race/ethnicity information as a single item: non-Hispanic White, non-Hispanic Black, Hispanic, Asian and Pacific Islander, American Indian and Alaska Native. These contrasts compare each group with non-Hispanic Whites.
^iv Source: HCUP State Inpatient Databases disparities analysis file, 2006. This source categorizes race/ethnicity information as a single item: non-Hispanic White, non-Hispanic Black, Hispanic, Asian and Pacific Islander. These contrasts compare each group with non-Hispanic Whites.

Key: NHOPI=Native Hawaiian or Other Pacific Islander; AI/AN=American Indian or Alaska Native.

Key to Symbols Used in Quality of Health Care Tables:
= Group and comparison group receive about same quality of health care or have similar outcomes.
↑ Group receives better quality of health care than the comparison group or has better outcomes.
↓ Group receives poorer quality of health care than the comparison group or has worse outcomes.
Blank cell: Reliable estimate for group could not be made.

Table 2.1a. Racial and Ethnic Differences in Effectiveness of Care (continued)

Core Report Measure	Racial Differenceⁱ					Ethnic Differenceⁱⁱ
Core Report Measure	Black	Asian	NHOPI	AI/AN	More than 1 Race	Hispanic
HIV and AIDS
New AIDS cases per 100,000 population age 13 and overⁱⁱⁱ	↓	↑	↓	=		↓
Maternal and Child Health
Children ages 19-35 months who received all recommended vaccines^iv	↓	=		=	=	=
Children ages 2-17 with advice about healthy eating^v	=	=			=	=
Children ages 3-6 who ever had their vision checked^v	=					↓
Children ages 2-17 who had a dental visit in the past year^v	↓	=			↓	↓
Children ages 2-17 with advice about physical activity^v	=	=			=	=

ⁱ Compared with Whites.
ⁱⁱ Compared with non-Hispanic Whites.
ⁱⁱⁱ Source: Centers for Disease Control and Prevention, 2007. This source categorizes race/ethnicity information as a single item: non-Hispanic White, non-Hispanic Black, Hispanic, Asian, Native Hawaiian and Other Pacific Islander, American Indian and Alaska Native. These contrasts compare each group with non-Hispanic Whites.
^iv Source: National Immunization Survey, 2007.
^v Source: Medical Expenditure Panel Survey, 2006.

Key: NHOPI=Native Hawaiian or Other Pacific Islander; AI/AN=American Indian or Alaska Native.

Table 2.1a. Racial and Ethnic Differences in Effectiveness of Care (continued)

Core Report Measure	Racial Differenceⁱ					Ethnic Differenceⁱⁱ
Core Report Measure	Black	Asian	NHOPI	AI/AN	More than 1 Race	Hispanic
Mental Health and Substance Abuse
Adults with a major depressive episode in the last 12 months who received treatment for depression in the last 12 monthsⁱⁱⁱ	↓					↓
Suicide deaths per 100,000 population^iv	↑	↑		=		↑
People age 12 and over who needed treatment for illicit drug use or alcohol problem who received such treatmentⁱⁱⁱ	=					=
Respiratory Diseases
Adults age 65 and over who ever received pneumococcal vaccination^v	↓	↓				↓
Composite: Hospital patients with pneumonia who received recommended hospital care^vi	↓	↓		↓		↓
Patients with tuberculosis who completed a curative course of treatment within 1 year of treatment initiation^vii	=	=		↓		↓

ⁱ Compared with Whites.
ⁱⁱ Compared with non-Hispanic Whites.
ⁱⁱⁱ Source: Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health, 2007.
^iv Source: National Vital Statistics System-Mortality, 2006. This source did not collect information on Asians and NHOPIs separately but in aggregate as Asian and Pacific Islander. This source did not collect information for More than 1 Race.
^v Source: National Health Interview Survey, 2007.
^vi Source: CMS Quality Improvement Organization Program, 2007. This source categorizes race/ethnicity information as a single item: non-Hispanic White, non-Hispanic Black, Hispanic, Asian and Pacific Islander, American Indian and Alaska Native. These contrasts compare each group with non-Hispanic Whites.
^vii Source: CDC National TB Surveillance System, 2005. This source did not collect information on Asians and NHOPIs separately but in aggregate as Asian and Pacific Islander. This source did not collect information for More than 1 Race.

Key: NHOPI=Native Hawaiian or Other Pacific Islander; AI/AN=American Indian or Alaska Native.

Table 2.1a. Racial and Ethnic Differences in Effectiveness of Care (continued)

Core Report Measure	Racial Differenceⁱ					Ethnic Differenceⁱⁱ
Core Report Measure	Black	Asian	NHOPI	AI/AN	More than 1 Race	Hispanic
Lifestyle Modification
Adults with obesity who ever received advice to exercise moreⁱⁱⁱ	=				=	↓
Adult current smokers who received advice to quit smokingⁱⁱⁱ	=					↓
Adults with obesity who ever received advice about healthy eatingⁱⁱⁱ	↓				=	↓
Supportive and Palliative Care
Long-stay nursing home residents with physical restraints^iv	↑	↓		↓		↓
High-risk long-stay nursing home residents with pressure sores^iv	↓	=		↓		↓
Short-stay nursing home residents with pressure sores^iv	↓	=		=		↓
Functional Status Preservation and Rehabilitation
Adult home health care patients whose ability to walk or move around improved^v	=	=	=	=	=	=
Adult home health care patients who were admitted to the hospital^v	↓	↑	=	↓	↓	↓

ⁱ Compared with Whites.
ⁱⁱ Compared with non-Hispanic Whites.
ⁱⁱⁱ Medical Expenditure Panel Survey, 2006.
^iv Source: CMS Minimum Data Set, 2007. This source categorizes race/ethnicity information as a single item: non-Hispanic White, non-Hispanic Black, Hispanic, Asian and Pacific Islander. Contrasts compare each group with non-Hispanic Whites.
^v Source: CMS Outcome and Assessment Information Set, 2007.

Key: NHOPI=Native Hawaiian or Other Pacific Islander; AI/AN=American Indian or Alaska Native.

Table 2.1b. Socioeconomic Differences in Effectiveness of Care

Core Report Measure	Income Differenceⁱ			Educational Differenceⁱⁱ		Insurance Differenceⁱⁱⁱ
Core Report Measure	<100%	100-199%	200-399%	<HS	HS Grad	Uninsured
Cancer
Women age 40 and over who reported they had a mammogram within the past 2 years^iv	↓	↓	↓	↓	↓	↓
Breast cancer incidence per 100,000 women age 40 and over diagnosed at advanced stage^v
Adults age 50 and over who received a sigmoidoscopy, colonoscopy, or proctoscopy or fecal occult blood test within the last 2 years^iv	↓	↓	↓	↓	↓	↓
Colorectal cancer deaths per 100,000 population per year^vi				↓	↓
Diabetes
Composite: Adults with diabetes who had hemoglobin A1c measurement, dilated eye exam, and foot exam in the calender year^vii	↓	↓	=	↓	=	↓
Maternal and Child Health
Children ages 19-35 months who received all recommended vaccines^viii	↓	↓	=
Children ages 2-17 with advice about healthy eating^vii	↓	↓	↓			↓
Children ages 3-6 who ever had their vision checked^vii	↓	↓	↓			↓
Children ages 2-17 who had a dental visit in the past year^vii	↓	=	↓			↓
Children ages 2-17 with advice about physical activity^vii	↓	↓	=			↓

ⁱ Compared with persons with family incomes 400% of Federal poverty thresholds or above.
ⁱⁱ Compared with persons with any college education.
ⁱⁱⁱ Compared with persons under 65 with any private health insurance.
^iv Source: National Health Interview Survey, 2005.
^v Source: Surveillance, Epidemiology, and End Results Program, 2006.
^vi Source: National Vital Statistics System-Mortality, 2006.
^vii Source: Medical Expenditure Panel Survey, 2006.
^viii Source: National Immunization Survey, 2007.

Key: HS=high school.

Table 2.1b. Socioeconomic Differences in Effectiveness of Care (continued)

Core Report Measure	Income Differenceⁱ			Educational Differenceⁱⁱ		Insurance Differenceⁱⁱⁱ
Core Report Measure	<100%	100-199%	200-399%	<HS	HS Grad	Uninsured
Mental Health and Substance Abuse
Adults with a major depressive episode in the last 12 months who received treatment for the depression in the last 12 months^iv	=	=	=	=	=
Suicide deaths per 100,000 population^v
People age 12 and over who needed treatment for illicit drug use or alcohol problem who received such treatment^iv	↑	↑	=	=	↑
Lifestyle Modification
Adults with obesity who ever received advice to exercise more^vi	↓	↓	↓	↓	↓	↓
Adult current smokers who received advice to quit smoking^vi	=	=	=	=	=	↓
Adults with obesity who ever received advice about healthy eating^vi	↓	↓	↓	↓	=	↓
Respiratory Diseases
Adults age 65 and over who ever received pneumococcal vaccination^vii	↓	↓	=	↓	=

ⁱ Compared with persons with family incomes 400% of Federal poverty thresholds or above.
ⁱⁱ Compared with persons with any college education.
ⁱⁱⁱ Compared with persons under 65 with any private health insurance.
^iv Source: Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health, 2007.
^v Source: National Vital Statistics System-Mortality, 2006.
^vi Source: Medical Expenditure Panel Survey, 2006.
^vii Source: National Health Interview Survey, 2007.

Key: HS=high school.

Proceed to Next Section

Current as of March 2010

Internet Citation: Chapter 2. Quality of Health Care (continued, 5): National Healthcare Disparities Report, 2009. March 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://archive.ahrq.gov/research/findings/nhqrdr/nhdr09/Chap2e.html