National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (2)
- Behavioral Health (1)
- Cancer (1)
- Cardiovascular Conditions (1)
- Children/Adolescents (4)
- Chronic Conditions (4)
- COVID-19 (2)
- Depression (2)
- Diabetes (1)
- Disabilities (1)
- Disparities (13)
- Healthcare Costs (3)
- Healthcare Utilization (1)
- (-) Health Status (33)
- Hospitalization (2)
- Human Immunodeficiency Virus (HIV) (1)
- Infectious Diseases (1)
- Lifestyle Changes (5)
- Low-Income (5)
- Medicaid (1)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medicare (1)
- Mortality (2)
- Newborns/Infants (3)
- Nutrition (1)
- Obesity (1)
- Obesity: Weight Management (1)
- Outcomes (2)
- Pain (1)
- Policy (1)
- Pregnancy (1)
- Public Health (1)
- Quality of Care (1)
- Quality of Life (2)
- Racial and Ethnic Minorities (8)
- (-) Social Determinants of Health (33)
- Stress (2)
- Urban Health (2)
- Vaccination (1)
- Vulnerable Populations (2)
- Women (1)
- Young Adults (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 33 Research Studies DisplayedCheng TL, Mistry KB
AHRQ Author: Mistry KB
Clarity on disparity: who, what, when, where, why, and how.
This purpose of this article was to explain a comprehensive framework of health disparities descriptors that can offer a systematic approach to advance the understanding of causes of health disparities and facilitate action steps to ensure health equity.
AHRQ-authored.
Citation: Cheng TL, Mistry KB .
Clarity on disparity: who, what, when, where, why, and how.
Pediatr Clin North Am 2023 Aug; 70(4):639-50. doi: 10.1016/j.pcl.2023.03.003..
Keywords: Disparities, Social Determinants of Health, Newborns/Infants, Mortality, Health Status, Racial and Ethnic Minorities, Access to Care
Linton SL, Leifheit KM, McGinty EE
Association between housing insecurity, psychological distress, and self-rated health among US adults during the COVID-19 pandemic.
This research letter describes a survey study conducted to examine the association between housing insecurity and health during the COVID-19 pandemic. Data used was from wave 3 of the Johns Hopkins COVID-19 Civic Life and Public Health Survey, which was conducted online from November 11-30, 2020 using the National Opinion Research Center’s AmeriSpeak panel. The survey included 1218 participants who were 51% female, 560 participants aged 30 to 54 years, 549 participants aged 55 years or older; 13% self-identified as Hispanic, 13% self-identified as non-Hispanic Black, and 69% self-identified as non-Hispanic White. In November 2020, 128 participants (12%) reported housing insecurity. Among survey participants reporting housing insecurity, 42 reported being behind on housing payments, 55 reported having little to no confidence in their ability to make their next housing payment, and 31 reported both. Renters had disproportionately higher housing insecurity than homeowners, as did those were non-Hispanic Black race, were aged 30 to 54 years, earned less than $35,000 in 2019, lived with children, or resided in metropolitan counties. Forty-six percent of participants reported severe to moderate psychological distress and 18% reported fair to poor health. Participants with housing insecurity reported higher distress (57% vs 45%) and lower self-rated health (30% vs 16%). The association between housing insecurity and lower self-rated health was found to be statistically significant, while the association between housing insecurity and higher distress was not.
AHRQ-funded; HS000046.
Citation: Linton SL, Leifheit KM, McGinty EE .
Association between housing insecurity, psychological distress, and self-rated health among US adults during the COVID-19 pandemic.
JAMA Netw Open 2021 Sep;4(9):e2127772. doi: 10.1001/jamanetworkopen.2021.27772..
Keywords: COVID-19, Health Status, Stress, Social Determinants of Health
Fraiman YS, Litt JS, Davis JM
Racial and ethnic disparities in adult COVID-19 and the future impact on child health.
This article discusses the impact of the COVID-19 pandemic on children who are racial and ethnic minorities and the disproportionate harm to them. The authors urge that COVID-19-focused research consider racial and ethnic disparity. The paper discusses the lasting and intergenerational impact of COVID-19 on communities of color, especially children, due to increase in stress, material hardship, food insecurity, and long-term school readiness.
AHRQ-funded; HS000063.
Citation: Fraiman YS, Litt JS, Davis JM .
Racial and ethnic disparities in adult COVID-19 and the future impact on child health.
Pediatr Res 2021 Apr;89(5):1052-54. doi: 10.1038/s41390-021-01377-x..
Keywords: COVID-19, Children/Adolescents, Racial and Ethnic Minorities, Disparities, Health Status, Social Determinants of Health
Roy B, Riley C, Herrin J
Associations between community well-being and hospitalisation rates: results from a cross-sectional study within six US states.
The objective of this study was to evaluate the association between community well-being, a positively framed, multidimensional assessment of the health and quality of life of a geographic community, and hospitalisation rates. The investigators found that community well-being was inversely associated with local hospitalisation rates. They suggest that in addition to health and quality-of-life benefits, higher community well-being may also result in fewer unnecessary hospitalisations.
AHRQ-funded; HS023000.
Citation: Roy B, Riley C, Herrin J .
Associations between community well-being and hospitalisation rates: results from a cross-sectional study within six US states.
BMJ Open 2019 Nov 27;9(11):e030017. doi: 10.1136/bmjopen-2019-030017..
Keywords: Hospitalization, Health Status, Quality of Life, Healthcare Utilization, Social Determinants of Health
Calthorpe LM, Pantell MS
Differences in the prevalence of childhood adversity by geography in the 2017-18 National Survey of Children's Health.
This study examined differences in childhood exposures to adverse childhood experiences (ACEs) by geography and determined whether geography moderates the relationship between ACE exposure and health outcomes including overall health, asthma, ADHD, and special health care needs. Cross-sectional data from 2017-2017 National Survey of Children’s Health (NSCH) was analyzed. Rural residency was associated with 1.29 times increased odds of exposure to 4+ ACEs compared to suburban residency. Urban residency status was observed to increase the association between ACEs and asthma.
AHRQ-funded; HS026383.
Citation: Calthorpe LM, Pantell MS .
Differences in the prevalence of childhood adversity by geography in the 2017-18 National Survey of Children's Health.
Child Abuse Negl 2021 Jan;111:104804. doi: 10.1016/j.chiabu.2020.104804..
Keywords: Children/Adolescents, Social Determinants of Health, Health Status
Zullo AR, Adams JW, Gantenberg JR
Examining neighborhood poverty-based disparities in HIV/STI prevalence: an analysis of Add Health data.
The purpose of the study was to estimate the effect of exposure to neighborhood poverty in adolescence on HIV/STI prevalence in early adulthood. The investigators found that strong evidence for neighborhood poverty-based differences in HIV/STI prevalence was not observed. They suggest that researchers should continue to investigate the effect of neighborhood-level socioeconomic position measures and, if warranted, identify etiologically relevant exposure periods.
AHRQ-funded; HS022998.
Citation: Zullo AR, Adams JW, Gantenberg JR .
Examining neighborhood poverty-based disparities in HIV/STI prevalence: an analysis of Add Health data.
Ann Epidemiol 2019 Nov;39:8-14.e4. doi: 10.1016/j.annepidem.2019.09.010..
Keywords: Children/Adolescents, Low-Income, Vulnerable Populations, Disparities, Social Determinants of Health, Human Immunodeficiency Virus (HIV), Infectious Diseases, Young Adults, Health Status
Campbell AD, Baker EH
Do income inequalities in higher weight status depend on social integration?
In this study, the investigators use data from the 2003-2008 National Health and Nutrition Examination Survey (NHANES) to examine whether the association between higher weight status and social integration varies by income. The investigators concluded that the association between income and higher weight status operates differently for women and men and is dependent, in part, on their level of social integration.
AHRQ-funded; HS013852.
Citation: Campbell AD, Baker EH .
Do income inequalities in higher weight status depend on social integration?
Soc Sci Res 2019 Sep;83:102301. doi: 10.1016/j.ssresearch.2019.04.014..
Keywords: Health Status, Obesity, Obesity: Weight Management, Social Determinants of Health
Rundle AG, Chen Y, Quinn JW
Development of a neighborhood walkability index for studying neighborhood physical activity contexts in communities across the U.S. over the past three decades.
To examine how urban form shapes physical activity and health over time, a measure of neighborhood walkability is needed that can be linked to cohort studies with participants living across the United States (U.S.) that have been followed over the past decades. In this study, the Built Environment and Health-Neighborhood Walkability Index (BEH-NWI), a measure of neighborhood walkability that can be calculated for communities across the United States between 1990 and 2015, was conceptualized, developed, and tested using data from the New York City Tri-State Area.
AHRQ-funded; HS026120.
Citation: Rundle AG, Chen Y, Quinn JW .
Development of a neighborhood walkability index for studying neighborhood physical activity contexts in communities across the U.S. over the past three decades.
J Urban Health 2019 Aug;96(4):583-90. doi: 10.1007/s11524-019-00370-4
.
.
Keywords: Urban Health, Lifestyle Changes, Health Status, Social Determinants of Health
Sonik RA, Parish SL, Mitra M
Association of health status with receipt of supplemental security income among individuals with severe disabilities and very low income and assets.
Supplemental Security Income (SSI) is a cash-transfer program for individuals with severe disabilities and very low incomes and assets. The investigators analyzed data from the first 12 waves of the 2008 panel of the Survey of Income and Program Participation. They found that there was a sharp decline in health status among eventual SSI recipients in the year before program entry and a modest improvement and stabilization in health status after entry. The investigators also discuss the limitations and implications of their study.
AHRQ-funded; HS026317.
Citation: Sonik RA, Parish SL, Mitra M .
Association of health status with receipt of supplemental security income among individuals with severe disabilities and very low income and assets.
JAMA Intern Med 2019 Jun;179(6):842-43. doi: 10.1001/jamainternmed.2018.8609..
Keywords: Health Status, Vulnerable Populations, Nutrition, Disabilities, Social Determinants of Health
Angraal S, Gupta A, Khera R
Association of access to exercise opportunities and cardiovascular mortality.
The purpose of this study is to examine the patterns of cardiovascular disease (CVD) mortality in varying degrees of access within the U.S. at the county level. The results indicate that access to exercise opportunities has a significant association with adjusted CVD mortality--higher access correlates with lower CVD mortality. Counties that have lower access to exercise facilities show a higher prevalence of obesity and diabetes in comparison with counties that have higher access. States with fewer people living in close proximity to a park have higher percentage of people who do not engage in any leisure physical activity. These results suggest means by which opportunities to increase access may be developed.
AHRQ-funded; HS023000.
Citation: Angraal S, Gupta A, Khera R .
Association of access to exercise opportunities and cardiovascular mortality.
Am Heart J 2019 Jun;212:152-56. doi: 10.1016/j.ahj.2019.02.010..
Keywords: Cardiovascular Conditions, Health Status, Mortality, Social Determinants of Health
Oates GR, Hamby BW, Bae S
Bikeshare use in urban communities: individual and neighborhood factors.
This study examined factors associated with bikeshare use in a metropolitan area in the southern United States. The study found that higher neighborhood socioeconomic disadvantage was associated with higher bikeshare use. Bikeshare was a viable transportation option in low-resource neighborhoods and may be an effective tool to improve the connectivity, livability, and health of urban communities.
AHRQ-funded; HS023009.
Citation: Oates GR, Hamby BW, Bae S .
Bikeshare use in urban communities: individual and neighborhood factors.
Ethn Dis 2017 Nov 9;27(Suppl 1):303-12. doi: 10.18865/ed.27.S1.303..
Keywords: Health Status, Social Determinants of Health, Urban Health
Roy B, Riley C, Herrin J
Identifying county characteristics associated with resident well-being: a population based study.
The authors aimed to identify county attributes that are independently associated with a comprehensive, multi-dimensional assessment of individual well-being. They identified twelve county-level factors that were independently associated with individual well-being scores. Collectively, these twelve factors explained 91% of the variance in individual well-being scores, and they represent four conceptually distinct categories: demographic; social and economic; clinical care; and physical environment.
AHRQ-funded; HS023000.
Citation: Roy B, Riley C, Herrin J .
Identifying county characteristics associated with resident well-being: a population based study.
PLoS One 2018 May 23;13(5):e0196720. doi: 10.1371/journal.pone.0196720.
.
.
Keywords: Health Status, Quality of Life, Social Determinants of Health
Berdahl T, McQuillan J
AHRQ Author: Berdahl T
Self-rated health trajectories among married Americans: do disparities persist over 20 years?
The purpose of this study is to understand self-rated health (SRH) trajectories by social location (race/ethnicity by gender by social class) among married individuals in the United States. It found that women are less healthy than men; people of color are less healthy than whites; lower educated individuals are less healthy than higher educated individuals. Women's health declined slower than men's but did not differ by race/ethnicity or education
AHRQ-authored.
Citation: Berdahl T, McQuillan J .
Self-rated health trajectories among married Americans: do disparities persist over 20 years?
J Aging Res 2018 Jan 11;2018:1208598. doi: 10.1155/2018/1208598.
.
.
Keywords: Disparities, Health Status, Social Determinants of Health
Parker TC, Mohammed A, Leong T
Rotavirus vaccination rate disparities seen among infants with acute gastroenteritis in Georgia.
The purpose of this study was to determine possible disparities and socio-economic differences in RV vaccination rates. The study conclude that racial disparities and socio-economic differences are not determinants in rotavirus vaccination rates; however, age and ethnicity have an effect on RV vaccine status.
AHRQ-funded; HS024338.
Citation: Parker TC, Mohammed A, Leong T .
Rotavirus vaccination rate disparities seen among infants with acute gastroenteritis in Georgia.
Ethn Health 2017 Dec;22(6):585-95. doi: 10.1080/13557858.2016.1244744..
Keywords: Disparities, Health Status, Newborns/Infants, Social Determinants of Health, Vaccination
Jackson BE, Oates GR, Singh KP
Disparities in chronic medical conditions in the Mid-South.
This study examined differences in socio-demographic characteristics and health behaviors relevant to chronic medical conditions (CMCs) in the Mid-South region (Alabama, Mississippi, Louisiana, Kentucky, Tennessee, and Arkansas), and identified subpopulations with increased burden of chronic disease. It concluded that in the Mid-South, race and gender disparities in the top five chronic conditions are more prominent among higher-income rather than lower-income individuals.
AHRQ-funded; HS023009.
Citation: Jackson BE, Oates GR, Singh KP .
Disparities in chronic medical conditions in the Mid-South.
Ethn Health 2017 Apr;22(2):196-208. doi: 10.1080/13557858.2016.1232805.
.
.
Keywords: Chronic Conditions, Disparities, Health Status, Racial and Ethnic Minorities, Social Determinants of Health
Stepanikova I, Oates GR
Perceived discrimination and privilege in health care: the role of socioeconomic status and race.
This study examined how perceived racial privilege and perceived racial discrimination in health care varied with race and socioeconomic status (SES). It found that in whites, higher income and education contributed to increased perceptions of privileged treatment and decreased perceptions of discrimination. The pattern was reversed in blacks, who reported more discrimination and less privilege at higher income and education levels.
AHRQ-funded; HS023009.
Citation: Stepanikova I, Oates GR .
Perceived discrimination and privilege in health care: the role of socioeconomic status and race.
Am J Prev Med 2017 Jan;52(1s1):S86-s94. doi: 10.1016/j.amepre.2016.09.024.
.
.
Keywords: Disparities, Health Status, Racial and Ethnic Minorities, Social Determinants of Health
Oates GR, Jackson BE, Partridge EE
Sociodemographic patterns of chronic disease: how the mid-south region compares to the rest of the country.
This descriptive study examines sociodemographic differences in the distribution of chronic diseases and health-related behaviors in the Mid-South versus the rest of the U.S., identifying subgroups at increased risk of chronic disease. It finds that the Mid-South population had increased rates of chronic disease and worse health-related behaviors than the rest of the U.S. Mid-South blacks had the highest percentages of obesity, diabetes, high blood pressure, and stroke of all subgroups.
AHRQ-funded; HS023009.
Citation: Oates GR, Jackson BE, Partridge EE .
Sociodemographic patterns of chronic disease: how the mid-south region compares to the rest of the country.
Am J Prev Med 2017 Jan;52(1s1):S31-s39. doi: 10.1016/j.amepre.2016.09.004.
.
.
Keywords: Chronic Conditions, Health Status, Lifestyle Changes, Social Determinants of Health
Stepanikova I, Bateman LB, Oates GR
Systemic inflammation in midlife: race, socioeconomic status, and perceived discrimination.
This study investigates social determinants of systemic inflammation, focusing on race, SES, and perceived discrimination. Data on 884 white and 170 black participants were obtained from the Survey of Midlife in the U.S., a cross-sectional observational study combining survey measures, anthropometry, and biomarker assay. It suggests that inflammation-reducing interventions should focus on blacks and individuals facing socioeconomic disadvantages, especially low education.
AHRQ-funded; HS023009.
Citation: Stepanikova I, Bateman LB, Oates GR .
Systemic inflammation in midlife: race, socioeconomic status, and perceived discrimination.
Am J Prev Med 2017 Jan;52(1s1):S63-s76. doi: 10.1016/j.amepre.2016.09.026.
.
.
Keywords: Disparities, Health Status, Racial and Ethnic Minorities, Social Determinants of Health
Cockerham WC, Hamby BW, Oates GR
The social determinants of chronic disease.
This review article addresses the concept of the social determinants of health (SDH), selected theories, and its application in studies of chronic disease. The health effects of SDH are initially discussed with respect to smoking and the social gradient in mortality. The article concludes with an examination of neighborhood disadvantage, social networks, and perceived discrimination in SDH research.
AHRQ-funded; HS023009.
Citation: Cockerham WC, Hamby BW, Oates GR .
The social determinants of chronic disease.
Am J Prev Med 2017 Jan;52(1s1):S5-s12. doi: 10.1016/j.amepre.2016.09.010.
.
.
Keywords: Chronic Conditions, Health Status, Lifestyle Changes, Social Determinants of Health
Arora A, Spatz E, Herrin J
Population well-being measures help explain geographic disparities in life expectancy at the county level.
This study investigated whether population well-being - a comprehensive measure of physical, mental, and social health - helps explain geographic variation in life expectancy. At the county level, it found that for every 1-standard-deviation (4.2-point) increase in the well-being score, life expectancy was 1.9 years higher for females and 2.6 years higher for males.
AHRQ-funded; HS023000.
Citation: Arora A, Spatz E, Herrin J .
Population well-being measures help explain geographic disparities in life expectancy at the county level.
Health Aff 2016 Nov 01;35(11):2075-82. doi: 10.1377/hlthaff.2016.0715.
.
.
Keywords: Disparities, Health Status, Low-Income, Social Determinants of Health
Steve SL, Tung EL, Schlichtman JJ
Social disorder in adults with type 2 diabetes: building on race, place, and poverty.
The authors reported on their narrative review of the literature that explores the associations between social disorder and diabetes-related health outcomes within vulnerable communities. They also proposed a multilevel ecosocial model for conceptualizing social disorder, specifically focusing on its role in racial disparities and its pathways to mediating diabetes outcomes.
AHRQ-funded; HS000078.
Citation: Steve SL, Tung EL, Schlichtman JJ .
Social disorder in adults with type 2 diabetes: building on race, place, and poverty.
Curr Diab Rep 2016 Aug;16(8):72. doi: 10.1007/s11892-016-0760-4.
.
.
Keywords: Diabetes, Low-Income, Health Status, Racial and Ethnic Minorities, Social Determinants of Health
Kaplan RM, Milstein A
AHRQ Author: Kaplan RM
Financial strain and cancer outcomes.
This editorial discusses an article by Lathan et al. in the same issue that documents the strong associations between socioeconomic status and longevity. The editorial argues that many of the variables in that article are measured with error and, as a result, the multivariable analysis resulted in only partial adjustment. Two variables of particular importance, education and ethnicity, are discussed.
AHRQ-authored.
Citation: Kaplan RM, Milstein A .
Financial strain and cancer outcomes.
J Clin Oncol 2016 May 20;34(15):1711-2. doi: 10.1200/jco.2016.66.8079.
.
.
Keywords: Cancer, Health Status, Healthcare Costs, Low-Income, Outcomes, Social Determinants of Health, Stress
Bradley EH, Canavan M, Rogan E
Variation in health outcomes: the role of spending on social services, public health, and health care, 2000-09.
This study found that states with a higher ratio of social to health spending (calculated as the sum of social service spending and public health spending divided by the sum of Medicare spending and Medicaid spending) had significantly better subsequent health outcomes for the following seven measures: adult obesity; asthma; mentally unhealthy days; days with activity limitations; and mortality rates for lung cancer, acute myocardial infarction, and type 2 diabetes.
AHRQ-funded; HS017589.
Citation: Bradley EH, Canavan M, Rogan E .
Variation in health outcomes: the role of spending on social services, public health, and health care, 2000-09.
Health Aff 2016 May;35(5):760-8. doi: 10.1377/hlthaff.2015.0814.
.
.
Keywords: Outcomes, Social Determinants of Health, Healthcare Costs, Health Status, Public Health
Bernard DM, Selden TM
AHRQ Author: Bernard DM, Selden TM
Access to care among nonelderly veterans.
This study compared access to care for nonelderly adult veterans versus comparable non-veterans, overall and within subgroups defined by simulated eligibility for health care from the Veterans Health Administration and by insurance status. Its results showed that uninsured Veterans, the most policy-relevant group, have better access to care than comparable non-veterans.
AHRQ-authored.
Citation: Bernard DM, Selden TM .
Access to care among nonelderly veterans.
Med Care 2016 Mar;54(3):243-52. doi: 10.1097/mlr.0000000000000508.
.
.
Keywords: Medical Expenditure Panel Survey (MEPS), Access to Care, Social Determinants of Health, Health Status
Strobino DM, Ahmed S, Mistry K
AHRQ Author: Mistry KB
Maternal depressive symptoms and attained size among children in the first 2 years of life.
The researchers evaluated the relation of maternal depressive symptoms with attained size and whether it is stronger for young children in low-income families. They found that odds of short stature were significantly increased at 6 months in the total sample and among low/middle-income families for children whose mothers reported symptoms. Other measures of attained size were not associated with depressive symptoms.
AHRQ-authored.
Citation: Strobino DM, Ahmed S, Mistry K .
Maternal depressive symptoms and attained size among children in the first 2 years of life.
Acad Pediatr 2016 Jan-Feb;16(1):75-81. doi: 10.1016/j.acap.2015.10.003.
.
.
Keywords: Depression, Newborns/Infants, Health Status, Pregnancy, Social Determinants of Health