as some of these cooperative data collection efforts require input and cooperation from each of the states, implementing the standards in states may be a delicate balance of allowing states to meet their own needs for data collection while promoting national-level comparability.

RECOMMENDATION 4-9: DHHS should prepare and disseminate implementation guidelines for the Office of Management and Budget (OMB) standards for collecting racial and ethnic data.

The panel notes that some agencies within DHHS have issued such guidelines. For example, the National Institutes of Health have issued guidelines for maintaining, collecting, and reporting racial and ethnic data in clinical research.

The Importance of SEP in Understanding Racial and Ethnic Health Disparities

In Chapters 2 and 3, we illustrated the interrelationships between race, ethnicity, and SEP. Because of the interrelationship of these variables, in order to accurately interpret racial and ethnic differences in health and health care it is important to consider differences within groups of different social and economic backgrounds. Therefore, where possible, the panel urges DHHS to report health and health care disparities across different levels of SEP. The specific SEP measures used may depend on the outcome of interest (for example, education level may be the most appropriate measure for examining preventive health knowledge and outcomes—such as the percent of women receiving a mammogram each year) or upon the availability of data. In any case, the department should make an effort to consider SEP differences in conjunction with racial and ethnic differences in its health disparities reports.

RECOMMENDATION 4-10: DHHS should, in its reports on health and health care, tabulate data on race and ethnicity classified across different levels of socioeconomic position.

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