At A Glance

The National Healthcare Disparities Report (NHDR) describes the quality of and access to care for multiple subgroups across the United States, and also represents a source of information for tracking the Nation's progress over time. The observed disparities vary by condition and population.

Overall, disparities in quality and access for minority groups and poor populations have not been reduced since the first NHDR. Based on 2000 and 2001 data compared with this year's 2004 and 2005 data (depending on the data source), the number of measures on which disparities have gotten significantly worse or have remained unchanged since the first NHDR is higher than the number of measures on which they have gotten significantly better for Blacks, Hispanics, American Indians and Alaska Natives, Asians, and poor populations.

While some of the biggest disparities in quality remain, progress has been made in reducing disparities. Some examples of disparities that have been reduced include:

• The disparity between Black and White hemodialysis patients with adequate dialysis was eliminated in 2005.
• The disparity between Asians and Whites who had a usual primary care provider was eliminated in 2004.
• The disparity between Hispanics and non-Hispanic Whites and between people living in poor communities and people living in high income communities for hospital admissions for perforated appendix was eliminated in 2004.
• Significant improvements were observed in childhood vaccinations for most priority populations.

This year, the NHDR also reports on the biggest disparities in quality documented over the years where there has not been improvement:

• Blacks had a rate of new AIDS cases 10 times higher than Whites.
• Asian adults age 65 and over were 50% more likely than Whites to lack immunization against pneumonia.
• American Indians and Alaska Natives were twice as likely to lack prenatal care in the first trimester as Whites.
• Hispanics had a rate of new AIDS cases over 3.5 times higher than that of non-Hispanic Whites.
• Poor children were over 28% more likely than high income children to experience poor communication with their health care providers.

The relationship between access to care and quality of care is complex. The 2007 NHDR shows that the uninsured face greater challenges than the insured in getting access to high quality health care. Moreover, based on analyses of a set of core quality measures, the factor most consistently related to better quality is whether a patient is insured.

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