Measuring racial/ethnic disparities in health care: Methods and practical issues

Health Services Research

Volumn 47, Issue 3 PART 2, 2012, Pages 1232-1254

  LêCook, Benjamin ^a   McGuire, Thomas G ^a   Zaslavsky, Alan M ^a  

^a HARVARD MEDICAL SCHOOL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANALYTIC METHOD; CONFERENCE PAPER; ETHNIC DIFFERENCE; HEALTH CARE ACCESS; HEALTH CARE COST; HEALTH CARE DISPARITY; HEALTH CARE NEED; HEALTH CARE ORGANIZATION; HEALTH CARE QUALITY; HEALTH CARE SYSTEM; HEALTH CARE UTILIZATION; HEALTH INSURANCE; HEALTH STATUS; HEALTH SURVEY; HUMAN; INSTITUTE OF MEDICINE; MENTAL HEALTH CARE; METHODOLOGY; OUTCOME ASSESSMENT; PATIENT PREFERENCE; RACE DIFFERENCE; RACISM; STATISTICAL ANALYSIS; UNITED STATES;

CONTINENTAL POPULATION GROUPS; ETHNIC GROUPS; HEALTH SERVICES ACCESSIBILITY; HEALTH SERVICES RESEARCH; HEALTHCARE DISPARITIES; HUMANS; PREJUDICE; RESEARCH DESIGN; RESIDENCE CHARACTERISTICS; SOCIOECONOMIC FACTORS; SOCIOLOGY, MEDICAL;

EID: 84861184371     PISSN: 00179124     EISSN: 14756773     Source Type: Journal    
DOI: 10.1111/j.1475-6773.2012.01387.x     Document Type: Conference Paper

References (69)

1. AHRQ. 2004. National Healthcare Disparities Report, 2004. Rockville, MD: Agency for Healthcare Research and Quality.
2. AHRQ. 2010. National Healthcare Disparities Report, 2009. Rockville, MD: Agency for Healthcare Research and Quality.
3. Alegria, M., P. Chatterji, K. Wells, Z. Cao, C. Chen, D. Takeuchi, J. Jackson, and, X. L. Meng,. 2008. " Disparity in Depression Treatment among Racial and Ethnic Minority Populations in the United States." Psychiatric Services 59 (11): 1264.
4. Alegria, M., C.-C. Chen, B. L. Cook, N. Duan, and, X-L. Meng,. In press. "Disparities in Mental Health Services: Results from the Collaborative Psychiatric Epidemiological Survey." Health Services Research.
5. Ashton, C. M., P. Haidet, D. A. Paterniti, T. C. Collins, H. S. Gordon, K. O'Malley, L. A. Petersen, B. F. Sharf, M. E. Suarez-Almazor, N. P. Wray, and, R. L. Street Jr., 2003. " Racial and Ethnic Disparities in the Use of Health Services: Bias, Preferences, or Poor Communication? " Journal of General Internal Medicine 18 (2): 146-52. (Pubitemid 36278952)
6. Ayanian, J., P. Cleary, J. Weissman, and, A. Epstein,. 1999. " The Effect of Patients' Preferences on Racial Differences in Access to Renal Transplantation." New England Journal of Medicine 341 (22): 1661-9.
7. Bago d'Uva, T., A. Jones, and, E. van Doorslaer,. 2009. " Measurement of Horizontal Inequity in Health Care Utilisation Using European Panel Data." Journal of Health Economics 28 (2): 280-9.
8. Baicker, K., A. Chandra, and, J. Skinner,. 2005. " Geographic Variation in Health Care and the Problem of Measuring Racial Disparities." Perspectives in Biology and Medicine 48 (1 suppl): S42-53.
9. Baicker, K., A. Chandra, J. S. Skinner, and, J. E. Wennberg,. 2004. " Who You Are and Where You Live: How Race and Geography Affect the Treatment of Medicare Beneficiaries." Health Affairs (Millwood). Suppl Web Exclusives: VAR33-44. [accessed February 7, 2012]. Available at.
10. Baldwin, M. L., and, W. G. Johnson,. 1996. " The Employment Effects of Wage Discrimination against Black Men." Industrial and Labor Relations Review 49: 302-16. (Pubitemid 126446255)
11. Balsa, A. I., Z. Cao, and, T. G. McGuire,. 2007. " Does Managed Health Care Reduce Health Care Disparities between Minorities and Whites? " Journal of Health Economics 26: 101-121. (Pubitemid 44908720)
12. Blanco, C., S. Patel, L. Liu, H. Jiang, R. Lewis-Fernandez, A. Schmidt, M. Liebowitz, and, M. Olfson,. 2007. " National Trends in Ethnic Disparities in Mental Health Care." Medical Care 45 (11): 1012-9.
13. Blinder, A., 1973. " Wage Discrimination: Reduced Form and Structural Elements." Journal of Human Resources 8 (4): 436-55.
14. Bloche, M. G., 2004. " Erasing Racial Data Erased Report's Truth." Washington Post. February 15.
15. Braddock, C. H., III, K. A. Edwards, N. M. Hasenberg, T. L. Laidley, and, W. Levinson,. 1999. " Informed Decision Making in Outpatient Practice: Time to Get Back to Basics." Journal of the American Medical Association 282 (24): 2313-20. (Pubitemid 30013062)
16. Braveman, P. A., C. Cubbin, S. Egerter, D. R. Williams, and, E. Pamuk,. 2010. " Socioeconomic Disparities in Health in the United States: What the Patterns Tell Us." American Journal of Public Health 100 (S1): S186.
17. Coffey, R. M., R. M. Andrews, and, E. Moy,. 2005. " Racial Ethnic, and Socioeconomic Disparities in Estimates of AHRQ Patient Safety Indicators." Medical Care 43 (3): I48-I57. (Pubitemid 40360696)
18. Collins, J. W., Jr., R. J. David, R. Symons, A. Handler, S. N. Wall, and, L. Dwyer,. 2000. " Low-Income African-American Mothers' Perception of Exposure to Racial Discrimination and Infant Birth Weight." Epidemiology 11: 337-9. (Pubitemid 30228205)
19. Cook, B. L., and, W. G. Manning,. 2009. " Measuring Racial/Ethnic Disparities across the Distribution of Health Care Expenditures." Health Services Research 44 (5p1): 1603-21.
20. Cook, B., T. McGuire, and, J. Miranda,. 2007. " Measuring Trends in Mental Health Care Disparities, 2000-2004." Psychiatric Services 58 (12): 1533-9.
21. Cook, B. L., T. G. McGuire, and, S. H. Zuvekas,. 2009a. " Measuring Trends in Racial/Ethnic Health Care Disparities." Medical Care Research and Review 66 (1): 23-48.
22. Cook, B. L., M. Alegria, J. Guo, and, J. Y. Lin,. 2009b. " Pathways and Correlates Connecting Exposure to the U.S. and Latinos' Mental Health." American Journal of Public Health 99 (12): 2247-54.
23. Cook, B. L., T. G. McGuire, A. M. Zaslavsky, and, E. Meara,. 2009c. " Adjusting for Health Status in Non-Linear Models of Health Care Disparities." Health Services Outcomes and Research Methodology 9 (1): 1-21.
24. Cook, B. L., T. McGuire, K. Lock, and, A. Zaslavsky,. 2010. " Comparing Methods of Racial and Ethnic Disparities Measurement across Different Settings of Mental Health Care." Health Services Research 45 (3): 825-47.
25. Cook, B., T. McGuire, M. Alegria, and, S. L. T. Normand,. 2011. " Crowd-out and Exposure Effects of Physical Comorbidities on Mental Health Care Use: Implications for Racial-Ethnic Disparities in Access." Health Services Research 46: 1259-80.
26. Cooper, L. A., J. J. Gonzales, J. J. Gallo, K. M. Rost, L. S. Meredith, L. V. Rubenstein, N. Y. Wang, and, D. E. Ford,. 2003. " The Acceptability of Treatment for Depression among African-American, Hispanic, and White Primary Care Patients." Medical Care 47: 9-89.
27. Cooper-Patrick, L., N. Powe, M. Jenckes, J. Gonzales, D. Levine, and, D. Ford,. 1997. " Identification of Patient Attitudes and Preferences Regarding Treatment of Depression." Journal of General Internal Medicine 12 (7): 431-8. (Pubitemid 27300560)
28. van Doorslaer, E., X. Koolman, and, A. Jones,. 2004. " Explaining Income-Related Inequalities in Doctor Utilisation in Europe." Health Economics 13: 629-47. (Pubitemid 39136256)
29. van Doorslaer, E., and, T. Van Ourti,. 2011. " Measuring Inequality and Inequity in Health and Health Care." In Oxford Handbook on Health Economics, edited by, S. Glied, and, P. Smith, pp. 837-69. Oxford, England: Oxford University Press.
30. Edwards, A. W., 2003. " Human Genetic Diversity: Lewontin's Fallacy." Bioessays 25: 798-801. (Pubitemid 36966380)
31. Fairlie, R,. 2005. " An Extension of the Blinder-Oaxaca Decomposition Technique to Logit and Probit Models." Journal of Economic and Social Measurement 30: 305-316.
32. Fisher, E. S., D. C. Goodman, A. Chandra, and, K. K. Bronner,. 2008. Disparities in Health and Health Care among Medicare Beneficiaries. Princeton, NJ: Robert Wood Foundation.
33. Fleurbaey, M., and, E. Schokkaert,. 2012. " Equity in Health and Health Care." In Handbook of Health Economics, Vol. 2, edited by, M. V. Pauly, T. G. McGuire, and, P. P. Barros, pp. 1003-92. Waltham, MA: North Holland.
34. Fournier, M., 2005. " Exploiting Information from Path Dependence in Oaxaca-Blinder Decomposition Procedures." Applied Economics Letters 12: 669-72. (Pubitemid 41341885)
35. Gordis, L., 1996. Epidemiology. Philadelphia, PA: W.B. Saunders Company.
36. Gravelle, H., 2003. " Measuring Income Related Inequality in Health: Standardisation and the Partial Concentration Index." Health Economics 12: 803-19. (Pubitemid 37220632)
37. Guevara, J. P., D. S. Mandell, A. L. Rostain, H. Zhao, and, T. R. Hadley,. 2006. " Disparities in the Reporting and Treatment of Health Conditions in Children: An Analysis of the Medical Expenditure Panel Survey." Health Services Research 41 (2): 532-49. (Pubitemid 43374285)
38. Hargraves, J., and, J. Hadley,. 2003. " The Contribution of Insurance Coverage and Community Resources to Reducing Racial/Ethnic Disparities in Access to Care." Health Services Research 38 (3): 809-29. (Pubitemid 36682488)
39. Horvitz Lennon, M., T. G. McGuire, M. Alegria, and, R. G. Frank,. 2009. " Racial and Ethnic Disparities in the Treatment of a Medicaid Population with Schizophrenia." Health Services Research 44 (6): 2106-22.
40. Hudson, J. L., G. E. Miller, and, J. B. Kirby,. 2007. " Explaining Racial and Ethnic Differences in Children's Use of Stimulant Medications." Medical Care 45 (11): 1068-75.
41. IOM. 2003. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academies Press.
42. Jha, A. K., E. S. Fisher, Z. Li, E. J. Orav, and, A. M. Epstein,. 2005. " Racial Trends in the Use of Major Procedures among the Elderly." New England Journal of Medicine 353 (7): 683-91. (Pubitemid 41175676)
43. Katz, J. N., 2001. " Patient Preferences and Health Disparities." Journal of the American Medical Association 286 (12): 1506-9. (Pubitemid 33015509)
44. Kawachi, I., N. Daniels, and, D. E. Robinson,. 2005. " Health Disparities by Race and Class: Why Both Matter." Health Affairs 24 (2): 343.
45. Kim, C. H., 2010. " Decomposing the Change in the Wage Gap between White and Black Men Over Time, 1980-2005: An Extension of the Blinder-Oaxaca Decomposition Method." Sociological Methods & Research 38 (4): 619-51.
46. Kirby, J. B., J. Hudson, and, G. E. Miller,. 2010. " Explaining Racial and Ethnic Differences in Antidepressant Use among Adolescents." Medical Care Research and Review 67: 342-63.
47. Kirby, J. B., G. Taliaferro, and, S. H. Zuvekas,. 2006. " Explaining Racial and Ethnic Disparities in Health Care." Medical Care 44 (5 suppl): I64-72. (Pubitemid 43755414)
48. Klick, J., and, S. Satel,. 2006. The Health Disparities Myth. Washington, DC: American Enterprise Institute.
49. Krieger, N., 2006. " If "Race" Is the Answer, What Is the Question-On "Race," Racism, and Health: A Social Epidemiologist's Perspective." Social Service Research Council. Is Race "Real"? An Web Forum [accessed on November 15, 2011]. Available at
50. Leroi, A. M., " A Family Tree in Every Gene." New York Times, March 14, 2005 [accessed on November 15, 2011]. Available at
51. Lewontin, R., 1972. " The Apportionment of Human Diversity." Evolutionary Biology 6: 391-98.
52. Massey, D. S., and, N. A. Denton,. 1993. American Apartheid: Segregation and the Making of the Underclass. Cambridge, MA: Harvard University Press.
53. McGuire, T. G., M. Alegria, B. L. Cook, K. B. Wells, and, A. M. Zaslavsky,. 2006. " Implementing the Institute of Medicine Definition of Disparities: An Application to Mental Health Care." Health Services Research 41 (5): 1979-2005. (Pubitemid 44434272)
54. National Research Council. 2004. " Statistical Analysis of Observational Data." In Measuring Racial Discrimination, edited by, R. M. Blank, M. Dabady, and, C. F. Citro, pp. 121-61. Washington, DC: National Academy Press.
55. Nussbaum, M. C., 2001. " Symposium on Amartya Sen's Philosophy: 5 Adaptive Preferences and Women's Options." Economics and Philosophy 17 (1): 67-88.
56. Oaxaca, R., 1973. " Male-Female Wage Differentials in Urban Labor Markets." International Economic Review 14 (3): 693-709.
57. Oaxaca, R., and, M. Ransom,. 1999. " Identification in Detailed Wage Decompositions." Review of Economics and Statistics 81 (1): 154-7.
58. Roemer, J., 2002. " Equality of Opportunity: A Progress Report." Social Choice and Welfare 19 (2): 455-71. (Pubitemid 36170822)
59. Sen, A., 1999. Development as Freedom. Oxford, England: Oxford University Press.
60. Sequist, T. D., and, E. C. Schneider,. 2006. " Addressing Racial and Ethnic Disparities in Health Care: Using Federal Data to Support Local Programs to Eliminate Disparities." Health Services Research 41 (4p1): 1451-68. (Pubitemid 44114608)
61. Shields, A. E., and, W. H. Crown,. In press. " Incorporating Genomic Information into Disparities Research Methods: Reducing Measurement Error and Selection Bias " Health Services Research.
62. Skinner, J., J. N. Weinstein, S. M. Sporer, and, J. E. Wennberg,. 2003. " Racial Ethnic, and Geographic Disparities in Rates of Knee Arthroplasty among Medicare Patients." New England Journal of Medicine 349 (14): 1350-9. (Pubitemid 37186214)
63. Stockdale, S. E., I. T. Lagomasino, J. Siddique, T. McGuire, and, J. Miranda,. 2008. " Racial and Ethnic Disparities in Detection and Treatment of Depression and Anxiety Among Psychiatric and Primary Health Care Visits." 1995-2005. Medical Care 46: 668-77.
64. USDHHS. 2000. Healthy People 2010: Understanding and Improving Health, 2nd Edition. Washington, DC: U.S. Department of Health and Human Services.
65. Wagstaff, A., and, E. Van Doorslaer,. 2000. " Income Inequality and Health: What Does the Literature Tell Us? " Annual Review of Public Health 21 (1): 543-67. (Pubitemid 30480334)
66. White, K., J. S. Haas, and, D. Williams,. In press. " Elucidating the Role of Place in Health Care Disparities: The Example of Racial/Ethnic Residential Segregation " Health Services Research.
67. Williams, D., In press. " Intersectionality of Race, SES and Gender in Health Disparities." Health Services Research.
68. Yun, M., 2004. " Decomposing Differences in the First Moment." Economics Letters 82: 275-80. (Pubitemid 38065215)
69. Zaslavsky, A. M., and, J. Z. Ayanian,. 2005. " Integrating Research on Racial and Ethnic Disparities in Health Care over Place and Time." Medical Care 43 (4): 303-7. (Pubitemid 40515619)