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Measuring Racial and Ethnic Disparities in Health Care
Contact: Cheryl Pedersen, (609) 275-2258
PRINCETON, N.J. (June 2, 2009)—Disparities in the quality of health care contribute to higher rates of disease, disability, and mortality in racial and ethnic minority groups. Although government agencies, academic institutions, and other organizations have called for improved data as a first step in identifying and developing strategies to eliminate disparities, data collection policies and regulations across public and private entities are largely uncoordinated and nonstandardized. A new policy brief from Mathematica Policy Research, Inc., examines recent federal and state activities aimed at strengthening the collection of health-related data on race, ethnicity, and primary language. It highlights three states—Massachusetts, California, and New Jersey—that implemented laws or regulations guiding data collection activities by hospitals, health plans, and government agencies to draw lessons for other states interested in addressing disparities.
Massachusetts has been at the forefront in establishing laws and regulations to mandate and standardize race and ethnicity data collection. Its Health Care Quality and Cost Council sets standards for collection of data by health plans, and recently enacted laws require hospitals to collect race and ethnicity data from patients. The state’s new Office of Health Equity will monitor data collection across state agencies. These data will be used to report on measures of health care quality and costs, stratified by race and ethnicity.
California also requires health plans to collect race and ethnicity data. In addition, all health plans in the state must provide language assistance services to members with limited English proficiency. However, health plans—particularly commercial ones—have encountered significant technical and financial challenges in collecting race and ethnicity data. Many plans have had to modify their information technology systems to accommodate new data fields; others find that members are unwilling to provide race and ethnicity information in surveys. Some plans have turned to indirect data collection methods, such as geocoding and surname analysis, due to low response rates to direct methods.
In New Jersey, the state government and New Jersey Hospital Association (NJHA) have collaborated to improve race, ethnicity, and language data collection in hospitals and government agencies. NJHA is working with hospitals, state agencies, and academics to standardize data collection; it has also developed patient education materials, staff training sessions, and a toolkit to facilitate implementation.
“Although most states have not undertaken significant activities to improve racial, ethnic, and language data collection, 46 states now have an Office of Minority Heath or similar office,” said Patricia Collins Higgins, co-author of the brief and a researcher at Mathematica. “More states recognize that they lack accurate data on racial and ethnic origins, which are vital to understanding the extent of disparities.”
The policy brief, “Measuring Racial and Ethnic Disparities in Health Care: Efforts to Improve Data Collection,” by Higgins and Erin Fries Taylor, is available at www.mathematica-mpr.com/publications/pdfs/Health/disparitieshealthcare.pdf. It was developed as part of a larger project funded by the Agency for Healthcare Research and Quality, in which Mathematica evaluated the second phase of the National Health Plan Collaborative to reduce racial and ethnic disparities.
Mathematica, a nonpartisan research firm, conducts high-quality, objective policy research and surveys to improve public well-being. Its clients include federal and state governments, foundations, and private-sector and international organizations. The employee-owned company, with offices in Princeton, N.J., Ann Arbor, Mich., Cambridge, Mass., Chicago, Ill., Oakland, Calif., and Washington, D.C., has conducted some of the most important studies of health care, education, family support, employment, nutrition, and early childhood policies and programs.