National Healthcare Disparities Report 2005

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Table 2.1a. Racial and Ethnic Differences in Effectiveness of Care

Core Report Measure	Racial Differenceⁱ					Ethnic Differenceⁱⁱ
	Black	Asianⁱⁱⁱ	NHOPIⁱⁱⁱ	AI/AN	>1 Race	Hispanic
Cancer
Women age 40 and over who had a mammogram within the past 2 years^iv	=	↓			=	↓
Rate of breast cancers diagnosed at late stage^v	=	↑		↑		↑
Cancer deaths per 100,000 female population per year for breast cancer^vi	↓	↑		↑		↑
Diabetes
Adults with diabetes who had hemoglobin A1c measurement, retinal eye exam, and foot exam in the past year^vii	=					↓
Hospital admissions for lower extremity amputations in patients with diabetes per 1,000 population^viii	↓
End Stage Renal Disease
Hemodialysis patients with urea reduction ratio 65% or higher^ix	↓	↑		=	=	↑
Dialysis patients registered on the waiting list for transplantation^x	↓	↑		↓		↓
Heart Disease
Current smokers age 18 and over receiving advice to quit smoking^vii	=					↓
Hospital care for heart attack patients^xi	↓	=		↓		↓
Deaths per 1,000 adult admissions with acute myocardial infarction (heart attack)^xii	↑	=				=
Hospital care for heart failure patients^xi	=	=		=		=
HIV and AIDS
HIV patients with CD4 <200 who receive PCP prophylaxis^xiii	=					=
New AIDS cases per 100,000 population 13 and over^xiv	↓	↑		=		↓
Maternal and Child Health
Pregnant women receiving prenatal care in first trimester^xv	↓	↑	↓	↓		↓
Infant mortality per 1,000 live births, birthweight <1,500 grams^xv	↓	↑	=	=		=
Children 19-35 months who received all recommended vaccines^xvi	↓	=	=	=	=	↓
Adolescents (13-15) who received 3 or more doses of hepatitis B vaccine^iv	=					=
Hospital admissions for pediatric gastroenteritis per 100,000 population^xii	=	↑				=
Children 2-17 with advice about physical activity^vii	=	=		↓	=	=
Children 2-17 with a dental visit^vii	↓	↓		↓	=	↓
Mental Health and Substance Abuse
Adults with serious psychological distress who receive mental health treatment or counseling^xvii	↓	↓				↓
Suicide deaths per 100,000 population^vi	↑	↑		↑		↑
Persons age 12 and over who needed treatment for substance abuse who received such treatment^xvii	=					↓
Patients receiving substance abuse treatment who completed treatment^xviii	↓					=
Respiratory Diseases
Persons 65 and over who ever received pneumococcal vaccination^iv	↓	↓				↓
Hospital care for pneumonia patients^xi	↓	=		=		=
Rate antibiotics prescribed at visits with a diagnosis of common cold per 10,000 population^xix	↑
Tuberculosis patients who complete course of treatment within 12 months of treatment initiation^xx	=	=		=		↓
Hospital admissions for asthma per 100,000 population under 18^xii	↓	↑				=
Nursing Home and Home Health Care
Long-stay nursing home residents who were physically restrained^xxi	↑	↓		=		↓
High risk long-stay nursing home residents with pressure sores^xxi	↓	=		↓		↓
Short-stay nursing home residents who have pressure sores^xxi	↓	=		=		↓
Home health care patients who get better at walking or moving around^xxii	=	↑	↑	=	=	=
Home health care patients who had to be admitted to the hospital^xxii	↓	↑	=	↓	=	↓

ⁱ Compared with Whites.

ⁱⁱ Compared with non-Hispanic Whites.

ⁱⁱⁱ Findings are presented separately for Asians and NHOPIs whenever possible. However, some data sources collected data for Asians and Pacific Islanders (APIs) as a single population; in these cases, the Asian and NHOPI cells are merged into a single cell representing APIs.

^iv Source: National Health Interview Survey, 2003.

^v Source: Surveillance, Epidemiology, and End Results program, 2002. This source does not provide rate estimates for Asians and NHOPIs separately but in aggregate as Asian and Pacific Islander. This source did not collect information for >1 race.

^vi Source: National Vital Statistics System-Mortality, 2002. This source did not collect information on Asians and NHOPIs separately but in aggregate as Asian and Pacific Islander. This source did not collect information for >1 race.

^vii Source: Medical Expenditure Panel Survey, 2002.

^viii Source: National Hospital Discharge Survey, 2001-2003. This source did not collect information for >1 race. Missing rates preclude analysis by ethnicity.

^ix Source: CMS End Stage Renal Disease Clinical Performance Measures Project, 2003.

^x U.S. Renal Data System, 2002. This source did not collect information on Asians and NHOPIs separately but in aggregate as Asian and Pacific Islander. This source did not collect information for >1 race.

^xi Source: CMS Quality Improvement Organization program, 2003. This source categorizes race/ethnicity information as a single item: non-Hispanic White, non-Hispanic Black, Hispanic, Asian and Pacific Islander, American Indian and Alaska Native. These contrasts compare each group with non-Hispanic Whites.

^xii Source: HCUP State Inpatient Databases disparities analysis file, 2002. This source categorizes race/ethnicity information as a single item: non-Hispanic White, non-Hispanic Black, Hispanic, Asian and Pacific Islander. These contrasts compare each group with non-Hispanic Whites.

^xiii Source: HIV Research Network, 2002. This source categorizes race/ethnicity information as a single item: non-Hispanic White, non-Hispanic Black, Hispanic, Asian and Pacific Islander, American Indian and Alaska Native. These contrasts compare each group with non-Hispanic Whites.

^xiv Source: Centers for Disease Control and Prevention, 2003. This source categorizes race/ethnicity information as a single item: non-Hispanic White, non-Hispanic Black, Hispanic, Asian and Pacific Islander. These contrasts compare each group with non-Hispanic Whites.

^xv Source: National Vital Statistics System-Natality, 2002. This source did not collect information for >1 race.

^xvi Source: National Immunization Survey, 2003.

^xvii Source: Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health, 2003.

^xviii Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set, 2002. This source categorizes race/ethnicity information as a single item: non-Hispanic White, non-Hispanic Black, Hispanic. These contrasts compare each group with non-Hispanic Whites.

^xix Source: National Ambulatory Medical Care Survey/National Hospital Ambulatory Medical Care Survey, 2001-2002. This source did not collect information for >1 race. Missing rates preclude analysis by ethnicity.

^xx Source: CDC National TB Surveillance System, 2001. This source did not collect information on Asians and NHOPIs separately but in aggregate as Asian and Pacific Islander. This source did not collect information for >1 race.

^xxi Source: CMS Minimum Data Set, 2003. This source categorizes race/ethnicity information as a single item: non-Hispanic White, non-Hispanic Black, Hispanic, Asian and Pacific Islander. Contrasts compare each group with non-Hispanic Whites.

^xxii Source: CMS Outcome and Assessment Information Set, 2003.

Key: NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native.

Key to Symbols Used in Quality of Health Care Tables:

= Group and comparison group receive about same quality of health care or have similar outcomes.

↑ Group receives better quality of health care than the comparison group or has better outcomes.

↓ Group receives poorer quality of health care than the comparison group or has worse outcomes.

Blank cell: Reliable estimate for group could not be made.

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