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ABSTRACT: To describe measurement challenges and strategies in identifying and analyzing health disparities and inequities.
We discuss the limitations of existing data sources for measuring health disparities and inequities, describe current strategies to address those limitations, and explore the potential of emerging strategies.
Larger national sample sizes are necessary to identify disparities for major population subgroups. Collecting self-reported race and granular ethnicity data may reduce some measurement errors, but it raises other methodological questions. The assessment of health inequities presents particular challenges, requiring analysis of the interactive effects of multiple determinants of health. Indirect estimation and modeling methods are likely to be important tools for estimating health disparities and inequities for the foreseeable future.
Interdisciplinary training and collaborative research models will be essential for future disparities research. Evaluation of evolving methodologies for assessing health disparities should be a priority for health services researchers in the next decade.
Health Services Research 10/2010; 45(5 Pt 2):1489-507. · 2.16 Impact Factor
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ABSTRACT: Healthy People 2010 is a comprehensive framework for improving the health of Americans, built on the foundation of several decades of predecessor initiatives. Its two overarching goals, to "[i]ncrease the quality and years of healthy life" and "[e]liminate health disparities," subsume 28 focus areas and comprise 955 objectives and subobjectives. This review evaluates progress toward meeting the Healthy People 2010 program's challenging agenda in the context of leading health indicator (LHI) measures, developed by the Department of Health and Human Services (DHHS), augmented by additional objectives for a total of 31 measures. Our evaluation of progress includes analysis of changes in objective values, including progress toward Healthy People 2010 targets, where appropriate, and analysis of changes in disparities. The Healthy People 2010 LHI measures suggest that although some progress has been made, there is much work to be done toward the Healthy People 2010 targets and both overarching goals.
Annual Review of Public Health 04/2010; 31:271-81 4 p folliwng 281. · 5.45 Impact Factor
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ABSTRACT: We sought to establish national data on the prevalence of visual impairment, blindness, and selected eye conditions (cataract, diabetic retinopathy, glaucoma, and macular degeneration) and to characterize these conditions within sociodemographic subgroups.
Information on self-reported visual impairment and diagnosed eye diseases was collected from 31,044 adults. We calculated weighted prevalence estimates and odds ratios with logistic regression using SUDAAN.
Among noninstitutionalized US adults 18 years and older, the estimated prevalence for visual impairment was 9.3% (19.1 million Americans), including 0.3% (0.7 million) with blindness. Lifetime prevalence of diagnosed diseases was as follows: cataract, 8.6% (17 million); glaucoma, 2.0% (4 million); macular degeneration, 1.1% (2 million); and diabetic retinopathy, 0.7% (1.3 million). The prevalence of diabetic retinopathy among persons with diagnosed diabetes was 9.9%.
We present the most recently available national data on self-reported visual impairment and selected eye diseases in the United States. The results of this study provide a baseline for future public health initiatives relating to visual impairment.
American Journal of Public Health 04/2008; 98(3):454-61. · 3.93 Impact Factor
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ABSTRACT: Background--Healthy People 2010 (HP2010) objectives are based on two overarching goals: 1) to increase years and quality of healthy life, and 2) to eliminate disparities among subgroups of the population. Four hundred and sixty-seven specific objectives consistent with these goals were outlined, baseline data were identified when available, and specific targets were set for the year 2010. This report discusses the techniques that are being used to measure progress toward these two goals. Process--In order to promote consistency in monitoring across different objectives, a minimum template of subgroups was adopted for the population-based objectives in HP2010. A workgroup of individuals representing the U.S. Department of Health and Human Services agencies involved in HP2010 was convened to consider the issues related to monitoring progress toward the two goals of HP2010. The workgroup concurred with the recommendations in this report. Recommendations--Progress toward target attainment can be monitored for all objectives with at least one data point beyond the baseline. For those objectives that are based on data for a population, progress toward target attainment can also be measured for subgroups of the population. Progress toward the elimination of disparity for individual population subgroups can be measured in terms of the percent difference between each subgroup rate and the most favorable or "best" subgroup rate in each domain. For purposes of measuring disparity relative to the "best" subgroup rate, all measures are expressed in terms of adverse events.
Healthy People 2010 statistical notes : from the Centers for Disease Control and Prevention/National Center for Health Statistics. 10/2004;
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Healthy People 2010 statistical notes : from the Centers for Disease Control and Prevention/National Center for Health Statistics. 08/2002;
