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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 21 of 21 Research Studies DisplayedSteenland MW, Wilson IB, Matteson KA
Association of Medicaid expansion in Arkansas with postpartum coverage, outpatient care, and racial disparities.
This study’s objective was to measure the association of Medicaid expansion in Arkansas with postpartum coverage, outpatient care, and racial disparities. A total of 60,990 childbirths were reviewed from January 1, 2014 on with a total of 72.3% paid for by Medicaid and 27.7% paid for by a commercial payer. The mean age of the birthing person was 27; with 67% White, 22% Black, and 7% Hispanic. Medicaid expansion in Arkansas was associated with a 27.8 percentage point increase in continuous insurance coverage and an increase in outpatient visits of 0.9 during the first 6 months postpartum, representing relative increases of 54.9% and 75.0%, respectively. Racial disparities in postpartum coverage decreased from 6.3 percentage points before expansion to -2.0 after. However, disparities in outpatient care after expansion persisted between Black and White individuals.
AHRQ-funded; HS027464.
Citation: Steenland MW, Wilson IB, Matteson KA .
Association of Medicaid expansion in Arkansas with postpartum coverage, outpatient care, and racial disparities.
JAMA Health Forum 2021 Dec;2(12):e214167. doi: 10.1001/jamahealthforum.2021.4167..
Keywords: Medicaid, Maternal Care, Pregnancy, Racial and Ethnic Minorities, Disparities, Policy, Women, Access to Care
Burris HH, Passarella M, Handley SC
Black-white disparities in maternal in-hospital mortality according to teaching and black-serving hospital status.
This study’s objective was to determine whether black-white disparities in maternal in-hospital mortality during delivery vary across hospital types (black-serving vs non-black and teaching vs non-teaching) and whether overall maternal mortality differs across hospital types. The authors performed a population-based, retrospective cohort study of 5,679,044 deliveries among black (14.2%) and white patients (85.8%) in 3 states (California, Missouri, and Pennsylvania) from 1995 to 2009. Examination of black-white disparities found that after risk adjustment, black patients had significantly greater risk of death and that the disparity was similar within each of the hospital types. At teaching hospitals, mortality was similar in black-serving and nonblack-serving hospitals. Among non-teaching hospitals, mortality was significantly higher in black-serving vs nonblack-serving hospitals. Over half (53%) of black patients delivered in nonteaching black-serving hospitals compared with just 19% of white patients.
AHRQ-funded; HS018661.
Citation: Burris HH, Passarella M, Handley SC .
Black-white disparities in maternal in-hospital mortality according to teaching and black-serving hospital status.
Am J Obstet Gynecol 2021 Jul;225(1):83.e1-83.e9. doi: 10.1016/j.ajog.2021.01.004..
Keywords: Maternal Care, Pregnancy, Mortality, Women, Racial and Ethnic Minorities, Disparities, Hospitals
Lange EMS, Toledo P
Peripartum racial/ethnic disparities.
Addressing disparities has been a focus of the US Department of Health and Human Services Healthy People initiative for decades, with the most recent Healthy People 2020 establishing a need for health equity in the United States. In this article, the investigators presented an overview of peripartum racial/ethnic disparities and address potential structural solutions to improve maternal health equity.
AHRQ-funded; HS025267.
Citation: Lange EMS, Toledo P .
Peripartum racial/ethnic disparities.
Int Anesthesiol Clin 2021 Jul 1;59(3):1-7. doi: 10.1097/aia.0000000000000326..
Keywords: Maternal Care, Pregnancy, Disparities, Racial and Ethnic Minorities, Women
Chen DW, Reyes-Gastelum D, Hawley ST
Unmet information needs among Hispanic women with thyroid cancer.
The authors sought to determine the relationship between acculturation level and unmet information needs among Hispanic women with thyroid cancer. They assessed acculturation with the Short Acculturation Scale for Hispanics. They found that low-acculturated (vs high-acculturated) Hispanic women with thyroid cancer have greater unmet information needs, emphasizing the importance of patient-focused approaches to providing medical information.
AHRQ-funded; HS024512.
Citation: Chen DW, Reyes-Gastelum D, Hawley ST .
Unmet information needs among Hispanic women with thyroid cancer.
J Clin Endocrinol Metab 2021 Jun 16;106(7):e2680-e87. doi: 10.1210/clinem/dgab128..
Keywords: Cancer, Women, Racial and Ethnic Minorities, Education: Patient and Caregiver, Cultural Competence
Pollack LM, Lowder JL, Keller M
Racial/ethnic differences in the risk of surgical complications and posthysterectomy hospitalization among women undergoing hysterectomy for benign conditions.
The objective of this retrospective cohort study was to evaluate whether 30- and 90-day surgical complication and postoperative hospitalization rates after hysterectomy for benign conditions differed by race/ethnicity and whether the differences remained after controlling for patient, hospital, and surgical characteristics. The investigators concluded that Black and Asian/Pacific Islander women had higher risk of some 30- and 90-day surgical complications after hysterectomy than white women. Black and Hispanic women had higher risk of posthysterectomy hospitalization.
AHRQ-funded; HS019455.
Citation: Pollack LM, Lowder JL, Keller M .
Racial/ethnic differences in the risk of surgical complications and posthysterectomy hospitalization among women undergoing hysterectomy for benign conditions.
J Minim Invasive Gynecol 2021 May;28(5):1022-32.e12. doi: 10.1016/j.jmig.2020.12.032..
Keywords: Surgery, Risk, Racial and Ethnic Minorities, Adverse Events, Hospitalization, Women
Wegienka G, Stewart EA, Nicholson WK
Black women are more likely than White women to schedule a uterine-sparing treatment for leiomyomas.
The purpose of this study was to evaluate differences in the proportion of uterine fibroid (UF) treatments that were uterine-sparing between Black women and White women and identify factors that could explain disparities. The investigators concluded that in these participants, Black women were more likely to schedule a uterine-sparing UF treatment and a nonsurgical UF treatment than their White counterparts; the researchers indicated that this may not be true for all women though.
AHRQ-funded; HS023418.
Citation: Wegienka G, Stewart EA, Nicholson WK .
Black women are more likely than White women to schedule a uterine-sparing treatment for leiomyomas.
J Womens Health 2021 Mar;30(3):355-66. doi: 10.1089/jwh.2020.8634..
Keywords: Women, Racial and Ethnic Minorities, Surgery
Hill LM, Lightfoot AF, Riggins L
Awareness of and attitudes toward pre-exposure prophylaxis among African American women living in low-income neighborhoods in a Southeastern city.
The authors conducted a venue-based community survey with 53 African American women living in low-income neighborhoods of a Southeastern city in order to understand women's knowledge of and attitudes toward pre-exposure prophylaxis (PrEP). They found that awareness of PrEP was very low, with only 16% being aware that PrEP is used for HIV prevention. The vast majority reported that they would use or would consider using PrEP, most frequently citing a general interest in HIV prevention or a lack of awareness of their partners' HIV status as motivations for their interest. Some women expressed concerns about side effects or low perceived HIV risk as disincentives for PrEP use.
AHRQ-funded; HS000032.
Citation: Hill LM, Lightfoot AF, Riggins L .
Awareness of and attitudes toward pre-exposure prophylaxis among African American women living in low-income neighborhoods in a Southeastern city.
AIDS Care 2021 Feb;33(2):239-43. doi: 10.1080/09540121.2020.1769834..
Keywords: Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Women, Low-Income, Prevention, Medication
Lee CI, Zhu W, Onega T
Comparative access to and use of digital breast tomosynthesis screening by women's race/ethnicity and socioeconomic status.
This study looked at access to digital breast tomography (DBT) versus regular mammography and whether women of minority race/ethnicity and lower socioeconomic status experienced lower DBT access during the early adoption period and persistently lower DBT use over time. This cross-sectional study included 92 geographically diverse imaging facilities across 5 US states, with over 2.3 million screening examinations performed among women aged 40 to 89 years from January 1, 2011, to December 31, 2017. Data were analyzed from June 2019, to August 2020. Women who used DBT increased for all women from 3.3% in 2011 to 82.6% in 2017. In 2012, Black, Hispanic, Asian American, and women with less than a high school education had lower DBT access compared to White women attending the same facility and also college graduates. Lower DBT access continued over time regardless of the number of years after facility-level DBT adoption.
AHRQ-funded; HS018366.
Citation: Lee CI, Zhu W, Onega T .
Comparative access to and use of digital breast tomosynthesis screening by women's race/ethnicity and socioeconomic status.
JAMA Netw Open 2021 Feb;4(2):e2037546. doi: 10.1001/jamanetworkopen.2020.37546..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Access to Care, Women, Social Determinants of Health, Racial and Ethnic Minorities, Screening
Safon CB, Heeren TC, Kerr SM
Disparities in breastfeeding among U.S. Black mothers: identification of mechanisms.
Disparities in U.S. breastfeeding rates persist among Black mothers according to birth country and between Black and White mothers, necessitating further investigation of modifiable mediating factors to inform interventions. This study sought to examine the extent that social, maternal, infant factors and Theory of Planned Behavior (TPB) domains (attitudes, perceived control, and subjective norms) mediated the association of maternal race/birth country and breastfeeding continuation.
AHRQ-funded; HS022242.
Citation: Safon CB, Heeren TC, Kerr SM .
Disparities in breastfeeding among U.S. Black mothers: identification of mechanisms.
Breastfeed Med 2021 Feb;16(2):140-49. doi: 10.1089/bfm.2020.0310..
Keywords: Breast Feeding, Racial and Ethnic Minorities, Disparities, Maternal Care, Women
Reese TJ, Schlechter CR, Potter LN
Evaluation of revised US Preventive Services Task Force lung cancer screening guideline among women and racial/ethnic minority populations.
The purpose of this study was to determine the changes associated with the revised USPSTF guideline for lung cancer screening eligibility among female, Black, and Hispanic populations using a large nationwide survey. The investigators concluded that the revised USPSTF guideline may likely increase lung cancer screening rates for female, Black, and Hispanic populations. However, despite these potential improvements, lung cancer screening inequities may persist without tailored eligibility criteria.
AHRQ-funded; HS026198.
Citation: Reese TJ, Schlechter CR, Potter LN .
Evaluation of revised US Preventive Services Task Force lung cancer screening guideline among women and racial/ethnic minority populations.
JAMA Netw Open 2021 Jan;4(1):e2033769. doi: 10.1001/jamanetworkopen.2020.33769..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Lung Cancer, Cancer, Screening, Racial and Ethnic Minorities, Women, Guidelines, Evidence-Based Practice
Bossick AS, Katon JG, Gray KE
Concomitant bilateral salpingo-oophorectomy at hysterectomy: differences by race and menopausal status in the Veterans Affairs health care system, 2007-2014.
This study compared race and menopausal status differences in the rate of concomitant bilateral salphino-oopherectomy (BSO) at hysterectomy in the Veterans Affairs health care system from 2007-2014. The authors identified 6,785 Veterans who underwent a hysterectomy, including 2,230 with concomitant BSO. After adjustment premenopausal Black Veterans had 41% lower odds of going through BSO than their White counterparts. There was insufficient evidence in postmenopausal Veterans. Black Veterans were more likely to be single, obese, and undergo abdominal hysterectomy.
AHRQ-funded; HS013853.
Citation: Bossick AS, Katon JG, Gray KE .
Concomitant bilateral salpingo-oophorectomy at hysterectomy: differences by race and menopausal status in the Veterans Affairs health care system, 2007-2014.
J Womens Health 2020 Dec;29(12):1513-19. doi: 10.1089/jwh.2020.8503..
Keywords: Surgery, Women, Racial and Ethnic Minorities
Mehra R, Boyd LM, Magriples U
Black pregnant women "get the most judgment": a qualitative study of the experiences of Black women at the intersection of race, gender, and pregnancy.
This qualitative study examined the experiences of Black pregnant women and how being stereotyped can cause stress. Semistructured interviews with 24 Black pregnant women in New Haven, Connecticut was conducted. The women were asked about their experience of being pregnant, experiences of gendered racism, and concerns related to pregnancy and parenting Black children. Many of the women experienced gendered racism stigmatizing Black motherhood that devalued Black pregnancies. They reported encountering assumptions that they were poor, single, and had multiple children regardless of socioeconomic status, marital status, or parity. This pregnancy stigma occurred in everyday, health care, social services, and housing-related contexts. This may contribute to poorer maternal and infant outcomes by way of reduced access to quality health care; impediments to services, resources, and social support; and poorer psychological health. Interventions to combat this problem include anti-bias training for health care and social service providers; screening for racialized pregnancy stigma and providing evidence-based coping strategy; creating pregnancy support groups; and developing broader societal discourse that values Black women and their pregnancies.
AHRQ-funded; HS017589.
Citation: Mehra R, Boyd LM, Magriples U .
Black pregnant women "get the most judgment": a qualitative study of the experiences of Black women at the intersection of race, gender, and pregnancy.
Womens Health Issues 2020 Nov-Dec;30(6):484-92. doi: 10.1016/j.whi.2020.08.001..
Keywords: Pregnancy, Women, Racial and Ethnic Minorities
Walter AW, Julce C, Sidduri N AW, Julce C, Sidduri N
Study protocol for the implementation of the Gabby Preconception Care System - an evidence-based, health information technology intervention for Black and African American women.
This hybrid type II implementation-effectiveness cohort study aimed at evaluating appropriateness, acceptability and feasibility implementation outcomes, while also systematically examining the clinical effectiveness of a preconception care (PCC) intervention, the Gabby System, for Black and African American women receiving health services in community-based sites. Contextual factors that influenced uptake and appropriate implementation strategies were identified to inform future scalability of the intervention.
AHRQ-funded; HS025131.
Citation: Walter AW, Julce C, Sidduri N AW, Julce C, Sidduri N .
Study protocol for the implementation of the Gabby Preconception Care System - an evidence-based, health information technology intervention for Black and African American women.
BMC Health Serv Res 2020 Sep 21;20(1):889. doi: 10.1186/s12913-020-05726-0..
Keywords: Racial and Ethnic Minorities, Women, Health Information Technology (HIT), Evidence-Based Practice, Community-Based Practice, Implementation
Payán DD, Maggard-Gibbons M, Flórez KR
Taking Care of Yourself and Your Risk for Breast Cancer (CUIDARSE): a randomized controlled trial of a health communication intervention for Latinas.
Latinas in the United States are more likely to be diagnosed with late-stage breast cancer (BC) compared to non-Latinas. Literacy-appropriate and culturally sensitive cancer communication interventions can help address existing racial/ethnic BC disparities. In this study, the investigators formatively developed a new BC prevention brochure for Spanish-speaking Latinas (≥35 years) and conducted a randomized controlled trial of a health communication intervention for Latinas.
AHRQ-funded; HS019264.
Citation: Payán DD, Maggard-Gibbons M, Flórez KR .
Taking Care of Yourself and Your Risk for Breast Cancer (CUIDARSE): a randomized controlled trial of a health communication intervention for Latinas.
Health Educ Behav 2020 Aug;47(4):569-80. doi: 10.1177/1090198120920529..
Keywords: Cancer: Breast Cancer, Cancer, Racial and Ethnic Minorities, Health Literacy, Education: Patient and Caregiver, Cultural Competence, Health Promotion, Communication, Women, Community-Based Practice
Pollack LM, Olsen MA, Gehlert SJ
Racial/ethnic disparities/differences in hysterectomy route in women likely eligible for minimally invasive surgery.
The objective of the study was to evaluate racial/ethnic variation in hysterectomy surgical route in women likely eligible for minimally invasive hysterectomy. The investigators concluded that African American, Hispanic, and Asian/PI women eligible for minimally invasive hysterectomy were more likely than White women to receive abdominal hysterectomy. In addition, the proportion of all women undergoing abdominal hysterectomy was highest at hospitals serving higher proportions of African American persons.
AHRQ-funded; HS019455; HS022330.
Citation: Pollack LM, Olsen MA, Gehlert SJ .
Racial/ethnic disparities/differences in hysterectomy route in women likely eligible for minimally invasive surgery.
J Minim Invasive Gynecol 2020 Jul-Aug;27(5):1167-77. doi: 10.1016/j.jmig.2019.09.003..
Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Racial and Ethnic Minorities, Women, Surgery
Toledo P, Lewis CR, Lange EMS
Women and underrepresented minorities in academic anesthesiology.
The demographics of the United States is changing with 51% of the population being female, and 32% of the population identifying as an underrepresented minority (URM, ie, African American/black, Hispanic/Latino, American Indian/Alaska Native, Native Hawaiian/Pacific Islander). This article provides an overview of the current status of women and URM faculty in academic anesthesiology and provides a framework for academic advancement.
AHRQ-funded; HS025267; HS026169.
Citation: Toledo P, Lewis CR, Lange EMS .
Women and underrepresented minorities in academic anesthesiology.
Anesthesiol Clin 2020 Jun;38(2):449-57. doi: 10.1016/j.anclin.2020.01.004..
Keywords: Provider: Physician, Provider, Workforce, Women, Racial and Ethnic Minorities, Education: Academic
Gaskin DJ, Karmarkar TD, Maurer A
Potential role of cost and quality of life in treatment decisions for arthritis-related knee pain in African American and Latina women.
This study examined whether using a decision-making tool would aid Latina and African-American women over age 45 years with arthritic knee pain in making more informed treatment decisions. The researchers conducted 4 focus groups of Latina and African-American women and 2 focus groups with primary care providers who treated them for knee pain. They found that minority women and primary care providers all endorsed the use of a decision-making tool that provided information on the impact of treatment on quality of life, medical care costs, and work productivity.
AHRQ-funded; HS000029.
Citation: Gaskin DJ, Karmarkar TD, Maurer A .
Potential role of cost and quality of life in treatment decisions for arthritis-related knee pain in African American and Latina women.
Arthritis Care Res 2020 May;72(5):692-98. doi: 10.1002/acr.23903..
Keywords: Arthritis, Orthopedics, Pain, Quality of Life, Healthcare Costs, Decision Making, Racial and Ethnic Minorities, Women
Glazer KB, Danilack VA, Werner EF
Elucidating the role of overweight and obesity in racial and ethnic disparities in cesarean delivery risk.
This study’s goal was to quantify the extent to which overweight and obesity explain cesarean delivery rates among women of different racial and ethnic backgrounds. Administrative records were used from New York City for 216,481 singleton, nulliparous births from 2008 to 2013. Risk ratios, risk differences, and population attributable fractions for associations between body mass index and cesarean, stratified by race and ethnicity was calculated. Black and Hispanic women had the highest cesarean rates attributable to obesity and overweight (17.4% and 14.6%) respectively.
AHRQ-funded; HS025013.
Citation: Glazer KB, Danilack VA, Werner EF .
Elucidating the role of overweight and obesity in racial and ethnic disparities in cesarean delivery risk.
Ann Epidemiol 2020 Feb;42:4-11.e4. doi: 10.1016/j.annepidem.2019.12.012.
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Keywords: Disparities, Racial and Ethnic Minorities, Pregnancy, Labor and Delivery, Risk, Obesity, Women
Lipira L, Rao D, Nevin PE
Patterns of alcohol use and associated characteristics and HIV-related outcomes among a sample of African-American women living with HIV.
The authors used baseline data from a randomized controlled trial of an HIV-related stigma-reduction intervention among African-American women living with HIV in Chicago and Birmingham. They measured patterns of alcohol use, then assessed demographic, social, and clinical characteristics which may influence alcohol use and HIV-related outcomes which may be influenced by patterns of alcohol use. Their findings suggest that alcohol use is common and associated with poor HIV-related outcomes in this population. They recommended that regular alcohol screening and intervention be offered.
AHRQ-funded; HS013853.
Citation: Lipira L, Rao D, Nevin PE .
Patterns of alcohol use and associated characteristics and HIV-related outcomes among a sample of African-American women living with HIV.
Drug Alcohol Depend 2020 Jan 1;206:107753. doi: 10.1016/j.drugalcdep.2019.107753..
Keywords: Human Immunodeficiency Virus (HIV), Alcohol Use, Racial and Ethnic Minorities, Women, Substance Abuse
Allgood KL, Rauscher GH, Whitman S
Validating self-reported mammography use in vulnerable communities: findings and recommendations.
The researchers examined the potential extent of overreporting of mammography use in low-income African-American and Latina women, and whether self-report inaccuracies might bias estimated associations between patient characteristics and mammography use. They found that although 73% of women self-reported a mammogram in the last 2 years, only 44% of self-reports were documented. Overreporting of mammography use was observed for all ethnic groups studied.
AHRQ-funded; HS018366.
Citation: Allgood KL, Rauscher GH, Whitman S .
Validating self-reported mammography use in vulnerable communities: findings and recommendations.
Cancer Epidemiol Biomarkers Prev 2014 Aug;23(8):1649-58. doi: 10.1158/1055-9965.epi-13-1253.
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Keywords: Healthcare Utilization, Vulnerable Populations, Racial and Ethnic Minorities, Women, Low-Income, Urban Health
Yaghjyan L, Wolin K, Chang SH
Racial disparities in healthy behaviors and cancer screening among breast cancer survivors and women without cancer: National Health Interview Survey 2005.
This study aimed to compare healthy behaviors and cancer screening practices among breast cancer survivors and respondents without cancer separately in Caucasian, African American, and Hispanic women. It found that most differences were suggestive and do not differ by race.
AHRQ-funded; HS022330.
Citation: Yaghjyan L, Wolin K, Chang SH .
Racial disparities in healthy behaviors and cancer screening among breast cancer survivors and women without cancer: National Health Interview Survey 2005.
Cancer Causes Control. 2014 May;25(5):605-14. doi: 10.1007/s10552-014-0365-7..
Keywords: Cancer: Breast Cancer, Cancer, Racial and Ethnic Minorities, Women, Disparities, Screening