National Healthcare Disparities Report, 2013
Chapter 6: Text Descriptions
Figure 6.1. Composite: Adults who had a doctor's office or clinic visit in the last 12 months who reported poor communication with health providers, by race/ethnicity, income, 2002-2010
| Race / Ethnicity / Income | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 |
|---|---|---|---|---|---|---|---|---|---|
| Total | 10.8% | 9.8% | 9.6% | 9.7% | 9.8% | 9.3% | 9.5% | 9.0% | 8.1% |
| White | 9.8% | 8.9% | 8.7% | 8.8% | 9.1% | 8.6% | 8.8% | 8.0% | 7.3% |
| Hispanic | 15.6% | 13.6% | 12.2% | 11.7% | 12.2% | 11.8% | 10.9% | 13.0% | 10.8% |
| Black | 11.5% | 11.0% | 11.0% | 12.7% | 10.3% | 10.5% | 12.1% | 11.7% | 10.2% |
| Poor | 15.7% | 15.2% | 15.8% | 15.0% | 13.4% | 13.6% | 14.1% | 15.9% | 13.1% |
| Low Income | 12.5% | 11.9% | 11.0% | 11.4% | 12.7% | 11.8% | 12.0% | 11.6% | 10.7% |
| Middle Income | 11.2% | 10.1% | 9.8% | 10.4% | 11.3% | 9.2% | 9.7% | 9.3% | 8.0% |
| High Income | 8.9% | 7.8% | 7.6% | 7.4% | 7.1% | 7.7% | 7.4% | 6.3% | 6.1% |
Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2010.
Denominator: Civilian noninstitutionalized population age 18 and over who had a doctor's office or clinic visit in the last 12 months.
Note: For this measure, lower rates are better. White and Black are non-Hispanic. Hispanic includes all races. Patients who report that their health providers sometimes or never listened carefully, explained things clearly, showed respect for what they had to say, or spent enough time with them are considered to have poor communication.
Figure 6.2. Composite: Adults who had a doctor's office or clinic visit who reported poor communication with health providers, by race/ethnicity, stratified by income, 2010
| Income | White | Black | Hispanic |
|---|---|---|---|
| Poor | 13.4% | 12.8% | 12.0% |
| Low Income | 9.3% | 13.2% | 13.4% |
| Middle Income | 7.3% | 8.6% | 10.6% |
| High Income | 5.8% | 7.7% | 7.2% |
| Total | 7.3% | 10.2% | 10.8% |
Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2010.
Denominator: Civilian noninstitutionalized population age 18 and over.
Note: For this measure, lower rates are better. White and Black are non-Hispanic. Hispanic includes all races. Patients who report that their health providers sometimes or never listened carefully, explained things clearly, showed respect for what they had to say, or spent enough time with them are considered to have poor communication.
Figure 6.3. Composite: Children who had a doctor's office or clinic visit in the last 12 months whose parents reported poor communication with health providers, by race/ethnicity and geographic location, 2002-2010
| Race / Ethnicity / Location | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 |
|---|---|---|---|---|---|---|---|---|---|
| White | 5.6% | 4.8% | 4.8% | 4.4% | 4.2% | 4.2% | 4% | 3.6% | 3.1% |
| Black | 7.1% | 7.5% | 6.3% | 5.7% | 4.8% | 5.1% | 4% | 5.1% | 4.3% |
| Hispanic | 10.2% | 8.4% | 7.9% | 8.8% | 7% | 6.8% | 5.8% | 7.4% | 5.9% |
| Total | 6.7% | 6.1% | 5.7% | 5.5% | 4.8% | 4.9% | 4.4% | 4.9% | 4% |
| Large Central MSA | 8.2% | 6.9% | 7.8% | 6% | 5.1% | 5.1% | 4.6% | 5.7% | 4.6% |
| Large Fringe MSA | 5.6% | 4.9% | 4.5% | 4.2% | 3.7% | 4.4% | 3.4% | 3.6% | 3.2% |
| Medium MSA | 6.4% | 6.5% | 4.2% | 6.7% | 5.7% | 5.6% | 4.9% | 4.7% | 3.9% |
| Small MSA | 6.9% | 6.6% | 5.3% | 4.4% | 4.9% | 4.2% | 7.1% | 6% | 4.2% |
| Micropolitan | 6.3% | 5.7% | 5.7% | 6% | 5.9% | 6.2% | 3.2% | 4.7% | 4.5% |
| Noncore | 6.4% | 5.1% | 6.3% | 6.3% | NA% | 3.8% | NA% | 6.1% | 3.7% |
Key: MSA = metropolitan statistical area.
Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2010.
Denominator: Civilian noninstitutionalized population under age 18 who had a doctor's office or clinic visit in the last 12 months.
Note: For this measure, lower rates are better. White and Black are non-Hispanic. Hispanic includes all races. Data for children in noncore areas in 2006 and 2008 did not meet criteria for statistical reliability. Parents who report that their child's health providers sometimes or never listened carefully, explained things clearly, showed respect for what they had to say, or spent enough time with them are considered to have poor communication.
Figure 6.4. Adult hospital patients who reported poor communication with nurses and doctors, by race, 2009-2012
| 2009 | 2010 | 2011 | 2012 | |
|---|---|---|---|---|
| Poor Communication With Nurses | ||||
| White | 5.3% | 5.0% | 4.8% | 4.3% |
| Black | 8.0% | 7.5% | 7.0% | 6.6% |
| Asian | 7.2% | 6.4% | 6.0% | 5.5% |
| NHOPI | 7.3% | 6.7% | 5.6% | 5.3% |
| AI/AN | 8.7% | 8.0% | 7.7% | 7.1% |
| >1 Race | 8.1% | 7.8% | 7.7% | 7.3% |
| Total | 5.9% | 5.6% | 5.3% | 4.9% |
| Poor Communication With Doctors | ||||
| White | 5.0% | 4.9% | 4.9% | 4.7% |
| Black | 6.0% | 5.9% | 5.7% | 5.6% |
| Asian | 5.5% | 5.2% | 5.0% | 4.7% |
| NHOPI | 5.4% | 5.4% | 4.5% | 4.7% |
| AI/AN | 7.5% | 7.2% | 7.2% | 6.9% |
| >1 Race | 7.4% | 7.6% | 7.6% | 7.6% |
| Total | 5.3% | 5.3% | 5.2% | 5.0% |
Key: NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native.
Source: Agency for Healthcare Research and Quality, Hospital CAHPS (Consumer Assessment of Healthcare Providers and Systems) Survey, 2009-2012.
Denominator: Adult hospital patients.
Note: For this measure, lower rates are better. Poor communication is defined as responded sometimes or never to the set of survey questions: "During this hospital stay, how often did doctors/nurses treat you with courtesy and respect?" "During this hospital stay, how often did doctors/nurses listen carefully to you?" and "During this hospital stay, how often did doctors/nurses explain things in a way you could understand?"
Figure 6.5. Provider-patient communication among adults receiving home health care, by race/ethnicity, 2012
| Race / Ethnicity | Always inform you about when they will arrive | Always explain things in a way you can understand | Always listen carefully to you | Always treat you as gently as possible | Always treat you with courtesy and respect |
|---|---|---|---|---|---|
| Total | 78.8% | 82.3% | 83.9% | 90.0% | 93.2% |
| White | 79.5% | 83.1% | 84.4% | 91.0% | 94.1% |
| Black | 81.1% | 84.2% | 86.0% | 90.1% | 93.2% |
| Asian | 70.1% | 71.2% | 74.1% | 78.7% | 83.6% |
| NHOPI | 78.5% | 79.7% | 81.0% | 86.0% | 88.6% |
| AI/AN | 76.2% | 80.7% | 81.9% | 88.1% | 90.9% |
| >1 Race | 77.5% | 82.4% | 82.7% | 89.1% | 92.0% |
| Hispanic | 76.9% | 81.4% | 85.8% | 88.2% | 92.5% |
Key: NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native.
Source: Centers for Medicare & Medicaid Services, Home Health Care CAHPS (Consumer Assessment of Healthcare Providers and Systems), 2011-2012.
Denominator: Adults who had at least two visits from a Medicare-certified home health agency during a 2-month look-back period. Patients receiving hospice care and who had "maternity" as the primary reason for receiving home health care are excluded.
Figure 6.6. Adults with limited English proficiency, by whether they had a usual source of care with or without language assistance, Hispanics and non-Hispanics, 2002-2010
| Year | Hispanics, No USC | Hispanics, USC Lang Assist - Yes | Hispanics, USC Lang Assist - No | Non-Hispanics, No USC | Non-Hispanics, USC Lang Assist - Yes | Non-Hispanics, USC Lang Assist - No |
|---|---|---|---|---|---|---|
| 2002 | 40.6 | 48.8 | 10.6 | 30.1 | 44.2 | 25.7 |
| 2003 | 55.5 | 40.6 | 3.9 | 32.5 | 50.0 | 17.6 |
| 2004 | 51.2 | 43.5 | 5.3 | 30.8 | 56.8 | 12.4 |
| 2005 | 54.3 | 43.0 | 2.7 | 38.5 | 49.5 | 12.0 |
| 2006 | 53.2 | 41.3 | 5.5 | 34.0 | 55.9 | 10.1 |
| 2007 | 52.5 | 44.0 | 3.5 | 34.0 | 42.0 | 24.0 |
| 2008 | 53.2 | 44.3 | 2.5 | 41.1 | 41.9 | 17.0 |
| 2009 | 52.6 | 43.8 | 3.6 | 38.5 | 46.9 | 14.6 |
| 2010 | 46.8 | 50.7 | 2.4 | 42.7 | 46.3 | 10.7 |
Key: USC = usual source of care.
Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2010.
Figure 6.7. Adults age 18 and over who needed an interpreter during last doctor visit (California only), by race/ethnicity and granular ethnicities, 2011
| Race / Ethnicity | Percent |
|---|---|
| Non-Hispanic White | 0.8 |
| All Asians | 3.8 |
| Chinese | 6.6 |
| Korean | 7.2 |
| Vietnamese | 9.6 |
| All Hispanics | 9.0 |
| Mexican | 9.3 |
| Central American | 11.5 |
| South American | 6.6 |
Key: NHW = Non-Hispanic Whites.
Source: University of California, Los Angeles, Center for Health Policy Research, California Health Interview Survey, 2011.
Denominator: Adults with previous doctor visit.
Note: Data were unavailable for Black, AI/AN, NHOPI, multiple-race, Puerto Rican, Filipino, Japanese, and South Asian individuals. Racial groups are non-Hispanic; Hispanic groups include all races.
Figure 6.8. Adults with a usual source of care whose health providers sometimes or never asked for the patient's help to make treatment decisions, by race/ethnicity and education, 2002-2010
| Race / Ethnicity / Education | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 |
|---|---|---|---|---|---|---|---|---|---|
| Hispanic | 27.6% | 21.6% | 17.2% | 20.0% | 17.0% | 18.5% | 18.4% | 18.9% | 17.7% |
| Black | 26.4% | 22.6% | 23.4% | 20.9% | 22.7% | 18.9% | 17.5% | 17.7% | 14.9% |
| White | 19.9% | 17.5% | 16.8% | 15.9% | 16.1% | 14.5% | 14.3% | 14.2% | 11.5% |
| Total | 21.9% | 18.9% | 17.7% | 17.2% | 17.3% | 15.9% | 15.6% | 15.4% | 13.2% |
| Any College | 19.4% | 16.7% | 16.2% | 16.5% | 15.7% | 15.0% | 14.5% | 14.2% | 12.0% |
| High School Grad | 22.6% | 20.0% | 18.8% | 18.3% | 17.2% | 16.0% | 16.2% | 16.8% | 14.6% |
| < High School | 25.9% | 23.0% | 20.2% | 20.3% | 20.1% | 19.7% | 18.7% | 19.8% | 16.6% |
Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2010.
Denominator: Civilian noninstitutionalized population with a usual source of care.
Note: For this measure, lower rates are better. White and Black are non-Hispanic. Education status applies to adults age 18 and over.
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