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Eliminating Health Disparities: Measurement and Data Needs
data; and (3) to identify critical gaps in the data and suggest ways in which they could be filled.
We note some specific distinctions the panel made in interpreting its charge. First, the panel reviewed a very broad set of data collection systems both within and outside DHHS. These systems include health surveys, administrative records, and records from private data systems. The research purposes and uses of these data collection systems are quite varied—some are used to understand broad determinants of health (e.g., the effect of income on mortality) while others are used to understand very specific outcomes of health care treatment (e.g., the effects of ethnicity and race on medical outcomes of patients with hypertension or diabetes). The panel focused only on the collection of data on race, ethnicity, and socioeconomic position (as the originating legislation called for), and added to that the collection of data on acculturation and language use because the panel believed these to be important correlates to understanding racial, ethnic, and socioeconomic aspects of health and health care. In making recommendations, the panel did not consider specific assessments of the cost of improved data collection but did broadly consider the costs of data collection among different types of data collection systems.
THE IMPORTANCE OF DATA ON RACE, ETHNICITY, SOCIOECONOMIC POSITION, AND ACCULTURATION AND LANGUAGE USE
High-quality data on race and ethnicity are necessary to identify and eliminate disparities in health and health care. Socioeconomic position (SEP)—income, wealth, and education—is important as both a mediator of racial and ethnic disparities and a further source of disparities. Low SEP, for example, is associated with limited access to the health care system, inadequate health information, and poor health practices. Acculturation (and its proxy measures language, place of birth, years in the United States, or generational status) is also related to health status; mismatches between the language spoken by health care providers and by patients can be a limiting factor in health care interactions and health information exchange. The panel therefore concluded that:
CONCLUSION 3-1: Measures of race and ethnicity should be obtained in all health and health care data systems.
CONCLUSION 3-2: Measures of socioeconomic position should, where feasible, be obtained along with data on race and ethnicity.