2012 National Healthcare Disparities Report

Chapter 2, Text Descriptions for Figures

Figure 2.1. Adults ages 50-75 who reported having colorectal cancer screening, by race and income, 2000, 2003, 2005, 2008, and 2010

Race20002003200520082010
White35.140.346.353.460.2
Black30.035.939.148.256.1
Asian22.728.331.347.547.8
AI/AN34.9 29.028.745.6
>1 Race38.140.936.539.353.5
 
Income20002003200520082010
Poor26.430.029.334.538.7
Low Income27.930.837.642.047.5
Middle Income32.738.243.449.657.4
High Income39.645.852.160.868.9

Key: AI/AN = American Indian or Alaska Native.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey, 2000, 2003, 2005, 2008, and 2010.
Denominator: Civilian noninstitutionalized population ages 50-75.
Note: Rates are age adjusted to the 2000 U.S. standard population. Colorectal cancer screening includes blood stool test in the past year, sigmoidoscopy in the past 5 years and blood stool test in the past 3 years, or colonoscopy in the past 10 years.

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Figure 2.2. State variation in disparities related to income: Adults ages 50-75 who reported having colorectal cancer screening, 2010

QuartileStates
Largest Disparity QuartileHawaii, Washington, Oregon, California, Idaho, Wyoming, Arizona, Kansas, Texas, Missouri, Louisiana, Georgia
Second QuartileNevada, Utah, New Mexico, North Dakota, South Dakota, Oklahoma, Wisconsin, Illinois, Michigan, Kentucky, Pennsylvania, North Carolina, South Carolina
Third QuartileMontana, Minnesota, Iowa, Indiana, Ohio, Tennessee, Mississippi, Alabama, Florida, Virginia, New Jersey, Connecticut, New Hampshire
Smallest Disparity QuartileAlaska, Colorado, Nebraska, Arkansas, West Virginia, Maryland, Delaware, New York, Vermont, Massachusetts, Rhode Island, Maine

Key: Largest Disparity Quartile identifies States with the largest relative difference in rates of colorectal cancer screening between poor and high-income adults; Smallest Disparity Quartile identifies States with the smallest relative differences in rates of colorectal cancer screening between poor and high-income adults.
Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, 2010.

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Figure 2.3. Adults ages 50-64 who reported having colorectal cancer screening, by Asian and Hispanic granular ethnicities and English proficiency, California, 2005, 2007, and 2009

Asian Ethnicities
California TotalAsian TotalChineseFilipinoJapaneseKoreanVietnameseSouth AsianEnglish at HomeWell/Very WellNot Well/Not at All
51.146.747.750.752.235.940.345.754.649.438.9
Hispanic Ethnicities
California TotalHispanic TotalMexicanPuerto RicanCentral AmericanSouth AmericanEnglish at HomeWell/Very WellNot Well/Not at All
51.145.643.955.94553.951.751.637.7

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Figure 2.4. Adults age 50 and over who have advanced stage colorectal cancer, per 100,000 population, by race and ethnicity, 2000-2008

Race200020012002200320042005200620072008
White100.497.994.892.483.079.577.374.971.5
Black114.8113.3112.3112.7102.999.195.792.590.6
AI/AN68.368.666.265.759.255.154.960.552.1
API78.079.576.371.266.567.664.260.859.8
 
Ethnicity200020012002200320042005200620072008
Non-Hispanic White102.5100.097.094.885.181.779.377.173.9
Hispanic82.882.679.578.575.473.271.767.164.8

Key: API = Asian or Pacific Islander; AI/AN = American Indian or Alaska Native.
Source: Centers for Disease Control and Prevention, National Program of Cancer Registries and National Cancer Institute, Surveillance, Epidemiology, and End Results (SEER) Program, 2000-2008. Registries meeting United States Cancer Statistics publication criteria for every year, 2000-2008, are included and cover 90.1% of the total U.S. population. States excluded are Arkansas, Washington DC, Mississippi, North Carolina, South Dakota, Tennessee, and Virginia.
Denominator: Adults age 50 and over.
Note: For this measure, lower rates are better. Age adjusted to the 2000 U.S. standard population. Advanced stage colorectal cancer is defined as regional or distant stage.

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Figure 2.5. Patients with colon cancer who received surgical resection of colon cancer that included at least 12 lymph nodes pathologically examined, by race/ethnicity and income, 2004-2009

Race/Ethnicity200420052006200720082009
White55.360.767.477.381.584.2
Black54.458.966.576.080.182.1
Hispanic56.562.068.778.180.884.7
Asian59.165.069.476.581.583.8
NHOPI77.881.8  83.983.9
AI/AN41.755.760.474.476.178.8
 
Income200420052006200720082009
Total55.460.567.477.481.483.9
Poor55.859.867.078.383.985.7
Low Income53.859.066.776.580.783.2
Middle Income59.664.470.180.383.485.9
High Income61.667.570.480.084.287.0

Key: NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native.
Source: Commission on Cancer, American College of Surgeons and American Cancer Society, National Cancer Data Base, 2004-2009.
Denominator: U.S. population. White and Black are non-Hispanic; Hispanic includes all races.
Note: The 2006 and 2007 data for NHOPIs did not meet criteria for statistical reliability, data quality, or confidentiality.

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Figure 2.6. Patients with colon cancer who received surgical resection of colon cancer that included at least 12 lymph nodes pathologically examined, by Asian and Hispanic granular ethnicities, 2004-2009

Ethnicity200420052006200720082009
Asian Indian57.974.760.884.783.886.2
Chinese57.253.068.974.181.682.2
Filipino51.360.374.173.680.076.1
Japanese67.372.771.377.981.989.9
Korean63.664.866.177.277.786.6
Vietnamese54.768.769.372.882.583.0
 
Ethnicity200420052006200720082009
Mexican59.262.070.674.178.986.6
Cuban64.870.777.882.585.389.5
Puerto Rican46.251.057.767.670.577.4

Source: Commission on Cancer, American College of Surgeons and American Cancer Society, National Cancer Data Base, 2004-2009.
Denominator: U.S. population.
Note: Puerto Ricans include patients receiving cancer care in hospitals in Puerto Rico.

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Figure 2.7. Age-adjusted colorectal cancer deaths per 100,000 population, by race and ethnicity, 2004-2009

Race200420052006200720082009
Total18.017.517.216.916.516
White17.616.916.716.41615.6
Black24.724.824.323.522.922.3
API11.311.210.910.911.310.5
AI/AN12.112.011.211.513.812.8
 
Ethnicity200420052006200720082009
Non-Hispanic White17.917.217.016.716.315.8
Hispanic12.612.412.612.01212.2

Key: API = Asian or Pacific Islander; AI/AN = American Indian or Alaska Native.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System—Mortality, 2004-2009.
Denominator: U.S. population.
Note: For this measure, lower rates are better. Total rate is age adjusted to the 2000 U.S. standard population. Hispanic includes all races.

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Figure 2.8. Adults who received a blood pressure measurement in the last 2 years and can state whether their blood pressure was normal or high, by race/ethnicity and education, 1998, 2003, and 2008

Race/Ethnicity199820032008
Total90.190.492.9
White91.091.993.6
Black92.392.193.5
Hispanic83.683.289.0
 
Education199820032008
<High School83.782.987.7
High School Grad89.690.891.3
Any College92.993.794.9

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey, 1998, 2003, and 2008.
Denominator: Civilian noninstitutionalized population age 18 and over.
Note: Rates are age adjusted to the 2000 U.S. standard population. White and Black groups are non-Hispanic; Hispanic includes all races.

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Figure 2.9. Adults with hypertension whose blood pressure is under control, by race/ethnicity and income, 1988-1994, 1999-2002, 2003-2006, and 2007-2010

Race/Ethnicity1988-19941999-20022003-20062007-2010
Total23.129.436.245.9
Mexican American15.416.627.332.2
Black22.228.234.341.2
White23.830.637.549.7
 
Income1999-20022003-20062007-2010
Poor27.931.045.2
Low Income26.332.140.5
Middle Income30.433.053.3
High Income32.243.743.8

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Figure 2.10. Inpatient deaths per 1,000 adult hospital admissions with heart attack, by race/ethnicity and area income, 2001-2009

Race/Ethnicity200120022003200420052006200720082009
White100.297.288.283.378.372.466.359.954.5
Black95.288.284.075.267.660.857.648.447.6
Hispanic99.594.188.880.877.472.565.359.059.4
API91.396.785.685.677.083.572.861.159.0
 
Area Income200120022003200420052006200720082009
Q1 (Lowest)105.997.690.987.478.874.368.761.654.5
Q2100.894.590.282.979.273.767.160.156.8
Q398.590.383.578.074.269.966.056.153.1
Q4 (Highest)94.690.780.176.872.267.961.856.251.1

Key: API = Asian or Pacific Islander; Q1 represents the lowest income quartile and Q4 represents the highest income quartile based on the median income of a patient's ZIP Code of residence.
Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, Nationwide Inpatient Sample, State Inpatient Databases disparities analysis file, and AHRQ Quality Indicators modified version 4.1, 2001-2009.
Denominator: Adults age 18 and over admitted to a non-Federal community hospital in the United States with acute myocardial infarction as principal discharge diagnosis.
Note: For this measure, lower rates are better. Rates are adjusted by age, Major Diagnostic Category, All Payer Refined-Diagnosis Related Group risk of mortality score, and transfers into the hospital. White, Black, and API groups are non-Hispanic; Hispanic includes all races.

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Figure 2.11. Hospital patients with heart failure and left ventricular systolic dysfunction prescribed ACE inhibitor or ARB at discharge, by race/ethnicity, 2005-2010

Race/Ethnicity200520062007200820092010
Total82.685.289.792.193.894.9
White81.484.288.991.493.194.4
Black85.487.691.493.695.196.1
Hispanic82.985.289.492.594.494.6
AI/AN85.886.490.890.791.892.5
Asian81.584.989.992.695.495.4

Key: ACE = angiotensin-converting enzyme; ARB = angiotensin receptor blocker; AI/AN = American Indian or Alaska Native.
Source: Centers for Medicare & Medicaid Services, Medicare Quality Improvement Organization Program, 2005-2010.
Denominator: Patients hospitalized with a principal diagnosis of acute heart failure and left ventricular systolic dysfunction.
Note: White, Black, AI/AN, and Asian groups are non-Hispanic; Hispanic includes all races.

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Figure 2.12. Adult admissions for congestive heart failure per 100,000 population, by race/ethnicity and area income, 2001-2009

Race/Ethnicity200120022003200420052006200720082009
White414.6414.0372.8372.7365.4347.0326.3315.7306.6
Black1083.71041.3859.2938.1846.7862.4828.6766.3742.3
Hispanic483.9608.3616.9592.5503.5436.5408.6339.4336.8
API309.5307.9253.6289.7224.8213.5216.9214.7199.0
 
Area Income200120022003200420052006200720082009
Q1 (Lowest)610.9599.6598.9576.0557.2566.1511.4490.3480.2
Q2521.4518.3463.5450.3419.4413.0388.3373.7363.3
Q3427.5444.1397.5384.1377.8359.4335.9327.4322.0
Q4 (Highest)413.3376.7334.9347.1349.1333.8296.0299.2292.8

Key: API = Asian or Pacific Islander; Q1 represents the lowest income quartile and Q4 represents the highest income quartile based on the median income of a patient's ZIP Code of residence.
Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, Nationwide Inpatient Sample, State Inpatient Databases disparities analysis file, and AHRQ Quality Indicators modified version 4.1, 2001-2009.
Denominator: U.S. resident population age 18 and over.
Note: For this measure, lower rates are better. Rates are adjusted by age and gender. White, Black, and API groups are non-Hispanic; Hispanic includes all races.

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Figure 2.13. Adults who reported receiving a cholesterol check in the last 5 years, by race, 2011

Race2011
White77.3
NHOPI65.9

Key: NHOPI = Native Hawaiian or Other Pacific Islander.
Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, 2011.
Denominator: Adults age 18 and over.

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Figure 2.14. Adult admissions for congestive heart failure per 100,000 population, State of Hawaii, by granular ethnicity, 2008

Ethnicity2008
White197.1
Native Hawaiian372.5
Other Pacific Islander1383.4
Chinese218.7
Filipino354.7
Japanese132.5

Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, Hawaii State Inpatient Databases and AHRQ Quality Indicators modified version 4.1, 2008.
Denominator: Adults age 18 and over in Hawaii based on the Hawaii Health Survey.
Note: For this measure, lower rates are better. Rates are adjusted by age and gender using the total U.S. population for 2000 as the standard population.

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Current as of May 2013
Internet Citation: 2012 National Healthcare Disparities Report: Chapter 2, Text Descriptions for Figures. May 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/nhqrdr/nhdr12/chap2-text.html