Racial and Ethnic Health Disparities

The publications listed in this section include resources on racial and ethnic disparities in health as well as in health care.

Estimating the Cost of Racial and Ethnic Disparities looks at how higher rates of disease among different racial and ethnic groups place an economic burden on public programs and the health care system at large. The brief estimates that disparities in preventable disease rates among African Americans, Latinos, and whites will cost the health care system $23.9 billion in 2009 alone. (Urban Institute, September 2009)
The Economic Burden of Health Inequalities in the US discusses how disparities in health and health care affect the economy, either directly through the costs associated with providing care to a sicker and more disadvantaged group, or indirectly, such as causing losses in productivity due to illness. The report estimates these costs to show the potential economic benefits of decreasing racial and ethnic health inequalities, including how it could lower the cost of health reform. (Joint Center for Political and Economic Studies, September 2009)
Reducing Racial and Ethnic Health Disparities: Key Health Equity Provisions examines several measures in the health reform proposals that are before Congress that will address inequities in the health care system. (Families USA, August 2009)
Racial and Ethnic Health Disparities in TRICARE examines disparities in TRICARE, the Department of Defense health coverage program for members of the uniformed service and their dependents. Although disparities exist among TRICARE beneficiaries, black non-Hispanics and Hispanics appear to receive more equitable care under TRICARE than they do in other types of health plans. (Journal of the National Medical Association, July 2009)
Reducing Racial and Ethnic Disparities in Health Care: Partnerships between Employers and Health Plans looks at barriers that prevent such partnerships from forming and discusses strategies to encourage increased employer involvement in the future. Recent evidence suggests that employers are only moderately aware of disparities. Educating employers and employees on the causes and consequences of disparities, and promoting the business case for reducing disparities, may elevate disparities reduction as a priority. (Mathematica, July 2009)
Making Progress on Health Care Disparities assesses the progress made by the National Health Plan Collaborative (NHPC), a collection of health insurance companies and private and public organizations that works to improve the quality of health care for racial and ethnic minorities. The report looks at the NHPC’s activities that were designed to encourage and support health plans’ leadership in their work on disparities. It also assesses plans’ ability to collect data to better identify disparities. (Mathematica, June 2009)
Putting Women’s Health Care Disparities on the Map: Examining Racial and Ethnic Disparities at the State Level moves beyond national figures to quantify where disparities are greatest and provides a rare look at the wide variation among states. The report also documents disparities in the factors that influence health and access to care, such as income and education. (Kaiser Family Foundation, June 2009)
The Children's Health Insurance Program Reauthorization Act (CHIPRA): Addressing Racial and Ethnic Health Disparities examines four key provisions in the new law: investing in outreach, increasing access for legal immigrant children and pregnant women, increased funding for interpretation and translation services, and establishing new quality of care measures. It also includes action steps for advocates. (Families USA, June 2009)
Measuring Racial and Ethnic Disparities in Health Care: Efforts to Improve Data Collection examines recent federal and state activities aimed at strengthening the collection of health-related data on race, ethnicity, and primary language. It highlights three states, California, Massachusetts, and New Jersey, that have implemented laws or regulations regarding data collection activities by hospitals, health plans, and government agencies. (Mathematica, May 2009)
Health Care Reform: Critical to Closing the Gap for Communities of Color presents a more in-depth look at data on the uninsured, which reveal alarming racial and ethnic disparities in health coverage. (Families USA, March 2009)
Today's Topics in Health Disparities - Are Health Disparities Back on the National Agenda? Examining the Impact of a New Administration and Congress is an interactive webcast that examines the implications of the incoming administration and Congress. An expert panel takes a closer look at what types of policies and initiatives could emerge over the next few years and considers how the new Administration might prioritize efforts to eliminate health disparities. (Kaiser Family Foundation, December 2008)
An Unequal Burden: The True Cost of High-Deductible Health Plans for Communities of Color discusses the full costs associated with high-deductible health plans and why these expenses are disproportionately unaffordable for racial and ethnic minorities. It also examines several myths about health savings accounts (HSAs), which are often coupled with such health plans. (Families USA, September 2008)
Health Coverage in Communities of Color: Talking about the New Census Numbers takes a closer look at the 2007 uninsured data. The number of uninsured was considerably higher in 2007 than it was in 2000, and communities of color continue to bear the brunt of this crisis. This fact sheet looks at who is uninsured, where people get their health insurance, and why public programs are vital to communities of color. (Families USA, September 2008)
A Burden No Child Should Bear: How the Health Coverage System Is Failing Latino Children highlights Latino children’s access to common forms of coverage and the different factors that may affect their ability to obtain insurance and care. Disparities in health coverage put Latino children at a disadvantage from a young age, and the effects of these disparities can persist throughout their lives. (The National Council of La Raza, July 2008)
Disparities in Health and Health Care among Medicare Beneficiaries highlights the importance of understanding health care within local context, and of efforts to explore and address the underlying causes of disparities within and across regions. The study’s major findings include: the rate of leg amputation is four times greater for blacks than for whites; and, for evidence-based services such as screening mammography and testing for diabetes, disparities across states and regions are substantially greater than the differences by race. (Robert Wood Johnson Foundation, June 2008)
Disparities in Physician Care: Experiences and Perceptions of a Multi-Ethnic America presents the results of a survey of more than 4,000 U.S. adults from 14 racial and ethnic groups about their perceptions of the quality of physician care compared to those of whites. On each measure examined, at least five of the subgroups perceived their care to be significantly worse than care for whites, and in many instances, the groups were at least 15 percentage points more negative than whites. (Health Affairs, March 2008) (Subscription needed)
Racial and Ethnic Disparities in U.S. Health Care: A Chartbook provides easily accessible information on disparities in coverage, health status and mortality, access and quality of health care, and strategies for closing the gap. The chartbook’s goal is to help policymakers, teachers, researchers, and advocates begin to understand the health disparities in their communities and start to develop solutions. (The Commonwealth Fund, March 2008)
Racial and Ethnic Disparities in Medical and Dental Health, Access to Care, and Use of Services in US Children found that minority children experience multiple disparities in these areas of health care, and certain disparities were particularly marked for specific racial/ethnic groups. For example, asthma and speech problems are particularly problematic for African Americans, and unmet medical and dental needs are more common for Native Americans. (Pediatrics, January 2008)
Racial-Ethnic Inequality in Child Well-Being from 1985-2004: Gaps Narrowing, but Persist reports that, since 1985, racial and ethnic disparities in children’s health have decreased, which is largely due to behavioral changes such as decreases in violent crime and drug use, and increases in family income. Although these disparities have improved, the overall well-being of children in the U.S. is far below that of our international peers. (The Foundation for Child Development, January 2008)
Separate and Unequal: Racial Segregation and Disparities in Quality across U.S. Nursing Homes summarizes the findings from an article published in “Health Affairs,” which suggests that there is a link between racial segregation in nursing homes and disparities in the care that is provided to minorities. In order to ensure more equitable care for all residents, researchers recommend policy changes such as improving the payment structures for nursing homes with a high proportion of Medicaid residents, leveling the amount of money paid to nursing homes by Medicaid and private payers, and monitoring admissions practices. (The Commonwealth Fund, September 2007)
From Policy to Action: Addressing Racial and Ethnic Disparities at the Ground-Level outlines practical strategies that states and Medicaid programs are implementing to reduce disparities in health care. These strategies include:
- Collecting more information on the race and ethnicity of enrollees,
- Incorporating disparities reduction goals into health plan provider contracts,
- Linking monetary incentives to reducing disparities in health care,
- Analyzing utilization and performance data by race and ethnicity, and
- Increasing access to culturally and linguistically appropriate care.
(The Center for Health care Strategies, August 2007)
From Awareness to Action/Stakeholders' Strategies to Eliminate Racial and Ethnic Disparities describes steps taken by national and community stakeholders, as reported in individual consultations, to act on awareness of the existence of health gaps between minorities and the total population. (Summit Health Institute for Research and Education, Inc., March 2007)
Issue Brief: Racial and Ethnic Health Disparities focuses on the factors that influence health disparities and provides a framework for considering potential arenas for policy action. (Kaiser Permanente Institute for Health Policy, 2007)
Key Facts: Race, Ethnicity and Medical Care serves as a quick reference source on the health, health insurance coverage, access, and quality of health care of racial and ethnic groups in the United States. The report highlights data that show whether health care disparities are narrowing, widening, or persisting for specific racial and ethnic groups and presents newly collected data for people who identify with more than one group. (Kaiser Family Foundation, January 2007)
Kaiser Health Disparities Report: A Weekly Look at Race, Ethnicity and Health is a new resource available through a free weekly e-mail. It summarizes and synthesizes news coverage of minority health issues and highlights studies, initiatives, and journal articles that generally do not receive mainstream news coverage. It also provides a calendar of upcoming events related to health disparities. (Kaisernetwork.org, January 2007)
Racial and Ethnic Disparities in Adolescent Health and Access to Care used data from the National Health Interview Survey (NHIS) and the National Survey of Children’s Health (NSCH) to analyze the extent to which health status and health care access disparities may exist for Black and Hispanic adolescents. (Incenter Strategies, January 2007)
Racial and Ethnic Disparities in Health and Access to Care among Older Adolescents utilized sample data from the 2004 and 2005 National Health Interview Survey (NHIS) to analyze levels of uninsurance among older adolescents (ages 18-21). The analysis determined older adolescents have disproportionately high levels of uninsurance compared with the rest of the population, particularly if they are racial or ethnic minorities. (Incenter Strategies, January 2007)
National Healthcare Disparities Report verifies past research and findings that racial and ethnic health disparities still permeate the U.S. health care system at all levels. (Agency for Healthcare Research and Quality, updated 2006)
Racial and Ethnic Disparities in Health Care reviews the types of disparities minority populations face, several programs designed to reduce disparities, and proposals for future action. Also included is a list of expert sources with telephone numbers and helpful Web sites. (Alliance for Health Reform, November 2006)
Report of the Study Panel on Medicare and Disparities: Strengthening Medicare’s Role in Reducing Racial and Ethnic Health Disparities examines Medicare’s role in reducing racial and ethnic health disparities and puts forth 17 recommendations for policymakers on how Medicare can move towards this goal. (National Academy of Social Insurance, October 2006)
Health Care Disconnect: Gaps in Coverage and Care for Minority Adults investigates racial disparities found in the analysis of the 2005 Commonwealth Fund Biennial Health Insurance Survey. The survey indicates that Hispanic and African American adults are up to three times more likely to be uninsured than white adults. Only 20 percent of white adults were uninsured at some point during 2005, compared to 33 percent of African Americans and 62 percent of Hispanics. (The Commonwealth Fund, August 2006)
A New Strategy to Combat Racial Inequality in American Health Care Delivery addresses indisputable evidence of racial inequality in American health care. The author proposes a new strategy to combat discrimination using Title VI of the Civil Rights Act. (The National Academy of Social Insurance, August 2006)
The first "National Health Care Disparities Report" was issued by the Agency for Health Care Research and Quality in 2003. What Have We Learned and Where Do We Go From Here? Three Years of the National Healthcare Disparities Report is the title of a forum where panelists and audience members discussed how the report can inform policy, research, and efforts to improve quality and reduce disparities. (The Kaiser Family Foundation, April 2006)
Comparative Perspectives on Health Disparities, a series of four articles published in the Journal of Health Politics, Policy and Law, explores racial and ethnic disparities in health care and attempts to refocus the discussion on finding solutions. The articles are titled ”U.S. Policy on Health Inequalities: The Interplay of Politics and Research,” ”Reframing the Racial Disparities Issue for State Governments,” ”State Legislative Activities Related to the Elimination of Health Disparities,” and ”Reducing Racial and Ethnic Health Disparities: Exploring Outcome-Oriented Agenda for Research and Policy.” (The Commonwealth Fund, February 2006)
The National Healthcare Disparities Report annually monitors various aspects of racial and economic inequality in America. The 2005 report estimates that the inequality gap between the poor and the affluent is rapidly increasing, much more so than the gap between ethnic groups. Hispanics report the most inequality of any of the ethnic groups that were surveyed. (The Agency for Healthcare Research and Quality, January 2006)
Primary Care Doctors Who Treat Blacks and Whites provides new insight into possible explanations for the pervasive health disparities between African Americans and whites. (The Center for Studying Health System Change, August 2004)
Disparities in Patient Experiences, Health Care Processes, and Outcomes: The Role of Patient-Provider Racial, Ethnic, and Language Concordance documents ongoing racial and ethnic disparities in health care and links patient-physician race and ethnic concordance with higher patient satisfaction and better health care processes. (The Commonwealth Fund, July 2004)
Health Insurance Plans Addressing Disparities in Care: Challenges and Opportunities reports that half of responding companies now collect data on the race and ethnicity of their members. (America's Health Insurance Plans, June 2004)
A State Policy Agenda to Eliminate Racial and Ethnic Health Disparities provides state policy makers with a menu of interventions that have been implemented to address disparities in minority health and health care. (The Commonwealth Fund, June 2004)
This live call-in show, Ask the Experts, focused on racial and ethnic disparities in health care. A Web cast and transcript of the session are available. (Kaisernetwork.org, April 2004)
The Community Solutions to Health Disparities Database details projects and interventions that address health disparity challenges in our communities. (American Public Health Association, March 2004)
Kaisernetwork.org, the Kaiser Foundation's online news and information service, has recently added a new issue: Spotlight on Minority Health and Health Care Disparities. This feature is designed to provide up-to-date news and information about efforts to reduce racial and ethnic disparities in health care. (Kaisernetwork.org, October 2003)
Reducing Racial and Ethnic Health Disparities: Estimating the Impact of High Health Center Penetration in Low-Income Communities examines the relationship between health center penetration into medically underserved communities and the reduction of state-level health disparities. (The George Washington University Center for Health Services Research and Policy, September 2003)
The National Healthcare Disparities Report is the first report in an annual series that tracks disparities in health care delivery pertaining to racial and socioeconomic factors. (The Agency for Healthcare Research and Quality, July 2003)
Key Facts: Race, Ethnicity & Medical Care provides a selective review of the literature that is intended to serve as a quick reference on racial and ethnic disparities in health status, health coverage, and health care access and quality. (The Kaiser Family Foundation, June 2003)
The Insurance Gap and Minority Health Care, 1997-2001 reports that, despite a booming economy and increased national attention being focused on the problem, racial and ethnic disparities failed to improve. (The Center for Studying Health System Change, June 2002)
National Survey of Physicians Part I: Doctors on Disparities in Medical Care presents selected findings from a survey assessing physicians' views on whether the health care system treats patients unfairly based on several characteristics, including racial or ethnic background, sex, sexual orientation, monetary resources, fluency in English, educational status, and whether they have a disability. (The Kaiser Family Foundation, March 2002)
Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, a comprehensive report from the Institute of Medicine, concludes that racial and ethnic minorities tend to receive lower-quality health care than whites even when access-related factors, such as patients' insurance status and income, are controlled. (The Institute of Medicine, March 2002)
Race, Ethnicity and Preventive Services: No Gains for Hispanics compares key preventive care indicators according to race and ethnicity. (The Center for Studying Health System Change, January 2001)
Racial and Ethnic Disparities: Key Findings from the National Survey of American Families attempts to measure the comparative well-being of non-Hispanic whites, Asian and Pacific Islanders, blacks, Hispanics, and Native Americans. (The Urban Institute, February 2000)
Key Facts: Racial and Ethnic Differences in Medical Care provides data and research that can serve as a quick reference source on the health status, health coverage, and health care use within communities of color. (The Kaiser Family Foundation, October 1999)

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