The National Quality Forum (NQF) issue brief highlights challenges to removing health care quality disparities in the United States and summarizes initiatives taking place at all levels—national, regional and local—to address these issues. Previous reports by the Agency for Healthcare Research and Quality (AHRQ) and the Institute of Medicine (IOM) concluded that significant health care disparities still exist, particularly in chronic disease care, and that little progress was made in narrowing gaps in health care quality and access from 2000–2005.

A primary focus in addressing health care disparities is to increase the quantity and quality of data collection. Data stratification by patient characteristic (e.g., race, ethnicity, insurance status, age and others) is vital, because these types of data allow for documentation of specific places where disparities exist. However, few providers, health plans, or hospitals capture this data, and even fewer link them to performance measures.

This issue brief outlines large-scale efforts to improve data collection, such as efforts by states requiring hospitals to collect race/ethnicity data. The brief also lists several targeted interventions aimed at reducing disparities, i.e.,colorectal cancer screening, and describes initiatives at national, regional and local levels to address these issues. Technical work that will make the data collected more useful includes studies on the use of geocoding and surname analysis to create proxy variables for race, ethnicity, income, among others.

The last decade has seen a nationwide movement to address gaps in health care delivery. Now the health care system must use what has been learned in this decade to sponsor evidence-based and culturally tailored interventions for eliminating health disparities.