National Healthcare Disparities Report - LDI Health Economist

Introduction and Methods
(which includes HbA1c measurement, eye exam, flu vaccination, and foot exam) contributes to the overall
rate for the core measures group but not to the diabetes group rate, which uses the estimates from the four
supporting component measures.
Using the analytic approach previously described, we calculated the sum of measures that were identified as
better, worse, or the same (when considering subgroup differences) or that were improving, worsening, or
remaining the same over time (when considering trend data). The distribution of measures by subpopulation,
type of service, and type of measure (i.e., quality or access) is presented as a way to summarize the status of
health care quality and disparities in the United States.
Priority Populations
Whereas the NHQR charts show contrast by age, gender, insurance status, and geographic location, the
NHDR shows contrasts by:
n Race: White, Black, Asian, Native Hawaiian or Other Pacific Islander, American Indian or Alaska
Native, and more than one race. vii
n Ethnicity: Hispanic and non-Hispanic. viii
n Income: Poor, low income, middle income, and high income. ix
n Education: People with less than a high school education, x high school graduates, and people with
any college.
n Disabilities: Basic activity limitations (problems with mobility, self-care, domestic life, and activities
that depend on sensory functioning) and complex activity limitations (limitations experienced in
work and in community, social, and civic life). xi
Rates relative to standard reference groups are used to quantify the magnitude of disparities and to identify
the largest disparities specific groups face. For each group, the group rate was divided by the reference group
rate to calculate the relative rates for each measure, with each measure framed in the negative (e.g., the
likelihood of not receiving an immunization).
Chapter 1
In addition to the measures related to racial and ethnic groups, low-income groups, rural residents, and
people with special health care needs presented in the Priority Populations chapter of the NHDR, measures
pertaining to women, children, and older adults are presented in other chapters of the NHDR and include
comparisons.
vii
Asian includes the former category of Asian or Pacific Islander prior to Office of Management and Budget guidelines, when
information was not collected separately by group.
viii
Not all data sources collect information by race and ethnicity separately. In such cases, comparisons are made by combining
racial/ethnic group categories (e.g., comparing non-Hispanic Blacks and Hispanics with non-Hispanic Whites.)
ix
Unless otherwise indicated, throughout this report, poor is defined as having family income less than 100% of the Federal poverty
level (FPL); near poor or low income refers to income between 100% and 200% of the FPL; middle income refers to income between
200% and 400% of the FPL; and high income refers to income above 400% of the FPL. These are based on U.S. census poverty
thresholds for each data year, which are used for statistical purposes.
x
Less than a high school education refers to people who did not complete high school.
xi For the purpose of the NHDR, people with disabilities are those with physical, sensory, and/or mental health conditions who also
have an associated decrease in functioning in such day-to-day activities as bathing, walking, doing everyday chores, and/or engaging
in work or social activities.
National Healthcare Disparities Report, 2011
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