Disparities may be an indicator of differences in either health care quality or health or both.
Since disparities in health and health care among racial, ethnic, language, and SEP subgroups have been identified, several agencies and governments responsible for ensuring the functioning of health care and public health systems have begun efforts to address identified disparities. The Healthy People 2010 initiative and the Health Disparities Report Card cited previously in this chapter are examples of two disparity-monitoring efforts by the federal government. These reports and others like them will provide periodic updates on the status of disparities and will help to hold accountable those agencies responsible for supporting the effective functioning of the health care system. In the case of racial and ethnic disparities, there is the important additional role of assessing and ensuring compliance with civil rights laws. While the existence of disparities in health and health care does not automatically imply discrimination, the monitoring of racial and ethnic disparities and of changes in disparities is critical to identifying potential problem areas and investigating the possibility of discrimination.
If the ultimate goal is to eliminate disparities in health and health care, then it is essential to understand the mechanisms that cause them. Measur-