DHHS, 2003a).1 The purpose of this series of reports is to “track prevailing disparities in health care delivery as they relate to racial factors and socioeconomic factors in priority populations” (P.L. 106-129).
DHHS has implemented initiatives aimed at better understanding and addressing disparities. Eliminating health disparities is one of two primary goals of the Healthy People 2010 program. Some agencies within DHHS have implemented initiatives of their own to correspond to Healthy People 2010. The department has also initiated an educational campaign called Closing the Health Gap. A key element of this campaign is Take a Loved One to the Doctor Day, which is an effort to “encourage individuals to take charge of their health by visiting a health professional (a doctor, a nurse, a nurse practitioner, a physician assistant, or another health provider), making an appointment for a visit, attending a health event in the community, or helping a friend, neighbor, or family member do the same” (http://www.healthgap.omhrc.gov/index.htm).
The availability of high-quality data on race, ethnicity, and other characteristics of individuals receiving health care is critical to documenting disparities in health and health care. But there are many weaknesses in the data sources currently available.
National-level surveys sponsored or conducted by the federal government are rich in information on health and health care outcomes as well as other characteristics of individuals; but while most have large enough sample sizes to obtain reliable information about broad racial and ethnic groups (i.e., blacks and whites), sample sizes are often not large enough for analyses of smaller racial groups (e.g., American Indian and Alaska Native) or for analyses within some of the racial and ethnic groups (e.g., to analyze differences between individuals of Mexican descent and individuals from other Hispanic backgrounds).
Data from Medicare claims and enrollment files have been widely used for analysis of racial and ethnic disparities, but such data are not available for all enrollees or potential enrollees, nor do they include information to permit analysis for more refined categorizations of race and ethnicity.
We note that two versions of this report were released; the executive summaries of these versions were the only differences in the two releases. The first version was released in December 2003; a second version was released in February 2004. The second version contained what was the original executive summary of the report, which had been changed in the process of departmental review (see Pear, 2004). The key findings of these two releases of the report are different (see http://www.house.gov/reform/min/politicsandscience/example_disparities.htm for both versions of the executive summary).