Disparities/Minority Health

More data are needed to better identify health care disparities among American Indians and Alaska Natives

AHRQ's National Healthcare Disparities Report (NHDR) is an annual report to Congress on racial, ethnic, and socioeconomic disparities in American health care. Conditions targeted include cancer, diabetes, end stage renal disease, heart disease, respiratory disease, mental health, and substance abuse. Yet, due to the limited data available for American Indians and Alaska Natives, only 42 percent of measures of health care quality and access tracked in the 2004 NHDR could be used to assess disparities among these two groups. Patient safety data was particularly limited.

Data for American Indians and Alaska Natives needs to be improved to allow better targeting of interventions to reduce health care disparities among these groups and to monitor the success of these activities, suggests Ernest Moy, M.D., M.P.H., of the Agency for Healthcare Research and Quality. In a recent paper, he and colleagues analyzed the 2004 NHDR to identify gaps in data for American Indians and Alaska Natives. Data gaps were larger for those two groups than all other ethnic and racial groups. For example, 2004 NHDR data on all 149 measures of health care quality were available for blacks, on 95 percent of measures for Hispanics, on 63 percent for Asians, but only 55 percent for American Indians and Alaska Natives.

Of the 60 measures of access to health care that could be tracked, data were available for blacks and Hispanics on all measures, for Asians on 84 percent, and for American Indians and Alaska Natives on 52 percent. Overall, only 42 percent of measures of quality of care and access to care could be adequately assessed for American Indians and Alaska Natives. This was due to data collection issues (data on the two groups were simply not collected), estimation issues (groups were too small), large relative standard errors, and power issues (samples were not large enough to show a significant difference).

More details are in "Gaps in data for American Indians and Alaska Natives in the National Healthcare Disparities Report," by Dr. Moy, Colleen Ryan Smith, M.P.H., Patrik Johansson, M.D., M.P.H., and Roxanne Andrews, Ph.D., in The Journal of the National Center 13(1), pp. 52-69, 2006. Reprints (AHRQ Publication No. 06-R038) are available from the AHRQ Publication Clearinghouse.

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