Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2012 Jun;47(3 Pt 2):1232-54.
doi: 10.1111/j.1475-6773.2012.01387.x. Epub 2012 Feb 21.

Measuring racial/ethnic disparities in health care: methods and practical issues

Benjamin Lê Cook  1 , Thomas G McGuire, Alan M Zaslavsky
Affiliations
Review

Measuring racial/ethnic disparities in health care: methods and practical issues

Benjamin Lê Cook et al. Health Serv Res. 2012 Jun.

Abstract

Objective: To review methods of measuring racial/ethnic health care disparities.

Study design: Identification and tracking of racial/ethnic disparities in health care will be advanced by application of a consistent definition and reliable empirical methods. We have proposed a definition of racial/ethnic health care disparities based in the Institute of Medicine's (IOM) Unequal Treatment report, which defines disparities as all differences except those due to clinical need and preferences. After briefly summarizing the strengths and critiques of this definition, we review methods that have been used to implement it. We discuss practical issues that arise during implementation and expand these methods to identify sources of disparities. We also situate the focus on methods to measure racial/ethnic health care disparities (an endeavor predominant in the United States) within a larger international literature in health outcomes and health care inequality. EMPIRICAL APPLICATION: We compare different methods of implementing the IOM definition on measurement of disparities in any use of mental health care and mental health care expenditures using the 2004-2008 Medical Expenditure Panel Survey.

Conclusion: Disparities analysts should be aware of multiple methods available to measure disparities and their differing assumptions. We prefer a method concordant with the IOM definition.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The Institute of Medicine (IOM 2003, p. 4) Definition of Racial/Ethnic Healthcare Disparities
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. AHRQ. National Healthcare Disparities Report, 2004. Rockville, MD: Agency for Healthcare Research and Quality; 2004.
    1. AHRQ. National Healthcare Disparities Report, 2009. Rockville, MD: Agency for Healthcare Research and Quality; 2010.
    1. Alegria M, Chatterji P, Wells K, Cao Z, Chen C, Takeuchi D, Jackson J, Meng XL. “Disparity in Depression Treatment among Racial and Ethnic Minority Populations in the United States”. Psychiatric Services. 2008;59((11)):1264. - PMC - PubMed
    1. Alegria M, Chen C-C, Cook BL, Duan N, Meng X-L. “Disparities in Mental Health Services: Results from the Collaborative Psychiatric Epidemiological Survey.”. Health Services Research. In press.
    1. Ashton CM, Haidet P, Paterniti DA, Collins TC, Gordon HS, O'Malley K, Petersen LA, Sharf BF, Suarez-Almazor ME, Wray NP, Street RL., Jr “Racial and Ethnic Disparities in the Use of Health Services: Bias, Preferences, or Poor Communication?”. Journal of General Internal Medicine. 2003;18((2)):146–52. - PMC - PubMed

MeSH terms