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<h1>2016 National Healthcare Quality and Disparities Report</h1>
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<h2>Appendix D: Definitions Used in 2016 Report</h2>
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<div id="publication-toc-pager"><div class="previous"><a href="/research/findings/nhqrdr/nhqdr16/appendixc_datasources.html">Previous Page</a></div> <div> </div></div>
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<div id="publication-toc">
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<h3>Table of Contents</h3>
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<ul>
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<li><a href="/research/findings/nhqrdr/nhqdr16/index.html">2016 National Healthcare Quality and Disparities Report</a></li>
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<li><a href="/research/findings/nhqrdr/nhqdr16/acknowledgments.html">Acknowledgments</a></li>
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<li><a href="/research/findings/nhqrdr/nhqdr16/summary.html">Executive Summary</a></li>
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<li><a href="/research/findings/nhqrdr/nhqdr16/overview.html">Overview of Quality and Access in the U.S. Health Care System</a></li>
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<li><a href="/research/findings/nhqrdr/nhqdr16/access.html">Access and Disparities in Access to Health Care</a></li>
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<li><a href="/research/findings/nhqrdr/nhqdr16/quality.html">Quality and Disparities in Quality of Health Care</a></li>
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<li><a href="/research/findings/nhqrdr/nhqdr16/looking-forward.html">Looking Forward</a></li>
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<li><a href="/research/findings/nhqrdr/nhqdr16/references.html">References</a></li>
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<li><a href="/research/findings/nhqrdr/nhqdr16/appendixa-graphs.html">Appendix A. Selected Measure Data</a></li>
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<li><a href="/research/findings/nhqrdr/nhqdr16/appendixb1_accesstrends.html">Appendix B: Trends in Access, Quality and Disparities for Measures in 2016 Report</a></li>
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<li><a href="/research/findings/nhqrdr/nhqdr16/appendixc_datasources.html">Appendix C: Data Sources Used for 2016 Report</a></li>
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<li><a href="/research/findings/nhqrdr/nhqdr16/appendixd_definitions.html">Appendix D: Definitions Used in 2016 Report</a></li>
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</ul>
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</div>
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</div>
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</div>
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<article role="article" class="contextual-region node node--type-ahrq-publication node--view-mode-full clearfix" about="/research/findings/nhqrdr/nhqdr16/appendixd_definitions.html">
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<div class="main-content-no-sb2">
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<div class="field field--name-field-subtitle field--type-string field--label-hidden field__item">2016 National Healthcare Quality and Disparities Report</div>
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<div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><h2>Racial and Ethnic Groups</h2>
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<p>Racial and ethnic groups are defined according to <a href="https://www.gpo.gov/fdsys/granule/FR-1997-10-30/97-28653">Standards for the Classification of Federal Data on Race and Ethnicity</a>, issued by the Office of Management and Budget.</p>
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<p>The basic racial and ethnic categories for federal statistics and program administrative reporting are defined as follows:</p>
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<ol><li><strong>American Indian or Alaska Native.</strong> A person having origins in any of the original peoples of North and South America (iincluding Central America) and who maintains tribal affiliation or community attachment.</li>
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<li><strong>Asian.</strong> A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.</li>
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<li><strong>Black or African American.</strong> A person having origins in any of the black racial groups of Africa. Terms such as "Haitian" or "Negro" can be used in addition to "Black or African American."</li>
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<li><strong>Hispanic or Latino.</strong> A person of Cuban, Mexican, Puerto Rican, Central or South American, or other Spanish culture or origin, regardless of race. The term "Spanish origin" can be used in addition to "Hispanic or Latino."</li>
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<li><strong>Native Hawaiian or Other Pacific Islander.</strong> A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.</li>
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<li><strong>White.</strong> A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.</li>
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</ol><h2>Income</h2>
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<p>Income groups are based on the Federal Poverty Level (FPL) for a family of four:</p>
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<ul><li>Poor: Less than 100% of FPL.</li>
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<li>Low income: 100% to less than 200% of FPL.</li>
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<li>Middle income: 200% to less than 400% of FPL.</li>
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<li>High income: 400% or more of FPL.</li>
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</ul><p>The poverty guidelines are <a href="https://aspe.hhs.gov/poverty-guidelines">available online</a>.</p>
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<h2>Urban-Rural Areas</h2>
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<p>Urban and rural areas are defined based on the National Center for Health Statistics 2013 Urban-Rural Classification Scheme.</p>
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<ul><li>Metropolitan counties:
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<ul><li>Large central metro counties in metropolitan statistical area (MSA) of 1 million population that: (1) contain the entire population of the largest principal city of the MSA, or (2) are completely contained within the largest principal city of the MSA, or (3) contain at least 250,000 residents of any principal city in the MSA.</li>
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<li>Large fringe metro counties in MSA of 1 million or more population that do not qualify as large central.</li>
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<li>Medium metro counties in MSA of 250,000-999,999 population.</li>
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<li>Small metro counties in MSAs of less than 250,000 population.</li>
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</ul></li>
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<li>Nonmetropolitan counties:
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<ul><li>Micropolitan: Urban cluster population 10,000-49,999.</li>
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<li>Noncore: Nonmetropolitan counties that did not qualify as micropolitan.</li>
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</ul></li>
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</ul><p>More information, including a map showing county classifications, is <a href="https://www.cdc.gov/nchs/data_access/urban_rural.htm">available online</a>.</p>
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<h2>Activity Limitations</h2>
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<p>Activity limitations are classified as basic, complex, and neither:</p>
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<ul><li>Basic activity limitations include problems with mobility, self-care (activities of daily living), domestic life (instrumental activities of daily living), and activities that depend on sensory functioning (limited to people who are blind or deaf).</li>
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<li>Complex activity limitations include limitations experienced in work and in community, social, and civic life. For the purpose of the QDR, adults with disabilities are those with physical, sensory, and/or mental health conditions that can be associated with a decrease in functioning in such day-to-day activities as bathing, walking, doing everyday chores, and engaging in work or social activities.</li>
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</ul><p>The paired measure is intended to be consistent with statutory definitions of disability, such as the first criterion of the 1990 Americans With Disabilities Act and other federal program definitions of disability. The category "neither" refers to individuals with neither basic nor complex activity limitations, as defined here.</p>
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</article>
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<section class="row region region-citation">
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<div id="block-citation" class="contextual-region block block-ahrq block-citation">
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<div data-contextual-id="context_block:context=citation&reaction_id=blocks&block_id=68cfb074-24da-4680-9a96-cdb022b3ebb0:langcode=en|settings_tray::langcode=en" data-contextual-token="0sM5D0H4cHEYfmVuVeeIppcJ0FfPYaFT89wJH5g-FO8"></div>
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<div id="created-reviewed-citation" class="pad-bottom-sections">
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<div id="page-reviewed" class="body-copy-italic">Page last reviewed June 2018 </div>
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<div id="page-created" class="body-copy-italic">Page originally created June 2017</div>
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<div id="citation">
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<div class="twocolordiv">
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<div class="twocolordiv-content">
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<p>
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<span class="citation-hdr">Internet Citation:</span> Appendix D: Definitions Used in 2016 Report. Content last reviewed June 2018. Agency for Healthcare Research and Quality, Rockville, MD.<br>
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<span class="citation-url">https://archive.ahrq.gov/research/findings/nhqrdr/nhqdr16/appendixd_definitions.html</span>
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Agency for Healthcare Research and Quality <img alt="" src="/images/bottom_dot.gif"> 5600 Fishers Lane Rockville, MD 20857 <img alt="" src="/images/bottom_dot.gif">
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Telephone: (301) 427-1364
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