Progress Toward Elimination of Health Disparities

The following discussion highlights progress toward the elimination of health disparities. The disparities are illustrated in the Disparities Table (see Figure 1-2), which displays information about disparities among select populations for which data were available for assessment.

Numerous disparities in access to health care were observed among select populations. Among racial and ethnic groups, the white non-Hispanic population had the best group rate for health insurance (1-1), counseled about smoking cessation (1-3c), a source of ongoing care (1-4a, b, and c), usual primary care provider (1-5), difficulties or delays in obtaining needed health care (1-6), and delay or difficulty in getting emergency care (1-10). The black non-Hispanic population had the best rate for two of the subobjectives: persons counseled about physical activity (1-3a) and diet and nutrition (1-3b).

Females had better rates than males for health insurance (1-1); counseled about physical activity (1-3a), diet and nutrition (1-3b), and smoking cessation (1-3c); a source of ongoing care (1-4a, b, and c); usual primary care provider (1-5); and hospitalization for pediatric asthma (1-9a), uncontrolled diabetes (1-9b), and immunization-preventable pneumonia or influenza (1-9c). Males had the better rate for difficulties or delays in obtaining needed health care (1-6). The disparity between males and females for this objective increased by about 35 percentage points between 1996 and 1999.

Persons with at least some college had the best rate for counseling about physical activity (1-3a) and management of menopause (1-3h), usual primary care provider (1-5), and delay or difficulty in getting emergency care (1-10). The disparity between high school graduates and persons with at least some college having a usual primary care provider increased by about 10 percentage points between 1996 and 1999. High school graduates had the best rate for counseling about smoking cessation (1-3c). The middle/high-income population had the best rates for health insurance (1-1); counseled about physical activity (1-3a), smoking cessation (1-3c), and management of menopause (1-3h); a source of ongoing care (1-4a, b, and c); difficulties or delays in obtaining needed health care (1-6); hospitalization for pediatric asthma (1-9a), uncontrolled diabetes (1-9b), and immunization-preventable pneumonia or influenza (1-9c); and delay or difficulty in getting emergency care (1-10).

Disparities were observed for a number of objectives and subobjectives. The percentages of the American Indian or Alaska Native population and the Hispanic population that did not have health insurance (1-1) in 2003 were more than twice that of the white non-Hispanic population. Similarly, despite a decline in disparity between the poor and middle/high-income populations, lack of health insurance coverage among the poor and near-poor populations was more than three times that of the middle/high-income population.

Disparities were noted in the percentage of persons having a source of ongoing care (1-4). The disparity between the Hispanic population and the white non-Hispanic population exceeded 100 percent for all age groups; the level of disparity has been increasing for all ages and for persons aged 18 years and older (1-4a and c). A similar level of disparity was observed among the Asian and black non-Hispanic populations for persons under 18 years of age (1-4b). Between 1998 and 2003, the disparity between the black non-Hispanic and white non-Hispanic populations increased by 65 percentage points. Disparities of over 50 percent were also observed for objective 1-4 between the best income group (middle/high income) and the poor and near-poor populations.

Disparities in excess of 100 percent among income groups were observed between the poor and middle/high-income groups for hospitalizations for pediatric asthma (1-9a), uncontrolled diabetes (1-9b), and immunization-preventable pneumonia or influenza (1-9c).  Disparities between the near-poor and the middle/high-income groups ranged from 50 percent to 100 percent or more.

Persons of two or more races were three times as likely as white non-Hispanic persons to experience delay or difficulty in getting emergency care (1-10). Similarly, the poor and near-poor populations were about twice as likely as the middle/high-income population to have difficulty in obtaining emergency care. Persons with disabilities were three times as likely as those without disabilities to have difficulty in obtaining care.

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