Issue 12: September 2007

Racial and Ethnic Disparities in Access to and Quality of Health Care

Eliminating racial and ethnic disparities in health is a major national objective, one of two overall goals for Healthy People 2010. Efforts to eliminate health disparities must incorporate strategies to reduce racial and ethnic disparities in health care as well. These strategies are also a critical component of overall efforts to improve health care quality.

There is a pressing need for policy-makers to understand the degree to which race and ethnicity or other factors (e.g., insurance coverage, income, etc.) contribute to health care disparities. This knowledge will help shape interventions to eliminate disparities. This synthesis presents findings on the size and causes of racial and ethnic disparities in access to care followed by findings on disparities in quality of care.

Key Findings:

• Racial and ethnic disparities in access to and quality of care are pervasive although not universal. The largest access disparities are for Spanish-speaking Hispanics.
  
  
• Insurance coverage, income and other factors explain a portion of the disparities, but racial and ethnic gaps in access and quality remain after accounting for these factors
  
  
• After adjusting for other factors, disparities in recommended processes of care—the appropriate use of screening tests, medications, and laboratory tests—tend to be small or nonexistent. Disparities are larger for intermediate outcomes, newer therapies and invasive outcomes even after adjusting for other factors.
  
  

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