Disparities in Chronic Disease Management and Prevention: Findings from the 2006 National Healthcare Disparities Report

Research Objective: To examine changes over time in racial and ethnic disparities across a broad range of health care quality measures. Study Design: Data come from the 2006 National Healthcare Disparities Report, which compiled national estimates on 211 measures of health care quality from 3 dozen data sources. Measures cover the quality dimensions of effectiveness, safety, timeliness, and patient centeredness. Analyses focus on 22 selected core measures from the full measure set and comparisons of whites, blacks, Asians, American Indians and Alaska Natives and Hispanics. For each core measure, disparities are measured in both absolute and relative terms. Disparities for a baseline year and for the most current year of data are compared to assess trends in disparities. Principal Findings: Disparities in health care remain prevalent in the U.S. For most core quality measures, blacks (73%), Hispanics (77%), and poor people (71%) received worse quality care than their reference groups (whites and high income). For most measures for poor people (67%), disparities were increasing. Disparities were prevalent in preventive care including colorectal cancer screening, counseling for obesity and pneumonia. Colorectal cancer screening rates were significantly lower for blacks and Asians compared with whites. Obese blacks were less likely to be told they were overweight by their doctor or other health care provider. The proportion of adults age 65 and over who ever had a pneumococcal vaccine was significantly lower among blacks and Asians compared with whites, and among the poor and less educated. Disparities were increasing over time for chronic care. Blacks had 376% more pediatric asthma hospitalizations than whites in 2003. This was an increase of 25% compared to 2001. Poor people lacked recommended diabetes care 54% more often than people with high income in 2003. This was an increase of 9.5% compared to 2000. Conclusions: Tracking disparities over time is important to identify groups and areas in greatest need of intervention. Findings from the 2006 National Healthcare Disparities Report show that there are increasing disparities over time for chronic disease management and disparities in preventive care for all priority populations. However, better and improving quality was also observed for at least 1 measure for every population. Implications for Policy, Delivery, or Practice: Communities can use the findings from the annual National Healthcare Disparities Report Communities as national benchmarks to help track their progress in decreasing disparities in these diseases including colorectal cancer, obesity, pneumonia, asthma, diabetes and others.