Transcript THE COMMONWEALTH FUND Purpose • “The goal of this chartbook is to create an easily accessible resource that can help policy makers, teachers, researchers, and practitioners.

THE
COMMONWEALTH
FUND
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Purpose
• “The goal of this chartbook is to create an
easily accessible resource that can help
policy makers, teachers, researchers, and
practitioners begin to understand
disparities in their communities and to
formulate solutions.”
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COMMONWEALTH
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Highlights
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The Demographics of America
Disparities in Health Status and Mortality
Disparities in Access to Health Care
Disparities in Health Insurance Coverage
Disparities in Quality
Strategies for Closing the Gap
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Chart 2-2. Minority groups will compose almost half of the
U.S. population by 2050; the biggest increase will occur
within the Hispanic population.
Projected percentage change in racial/ethnic composition
of the United States population, 2000 to 2050
White, nonHispanic
2050
2000
3.8
2.5
8.0
5.3
Black
13
Hispanic
50
24
13
Asian
Other
69
15
Note: Numbers add up to more than 100 percent because of rounding and because some
categories are not mutually exclusive.
Note: “Other” includes the following categories: American Indian/Alaska Native, Native
Hawaiian/other Pacific Islander,
and two or more races.
Source: United States Census Bureau. U.S. Interim Projections by Age, Sex, Race and Hispanic
Origin. 2004.
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Chart 3-7. Seven of 10 blacks are either overweight or obese;
blacks are substantially more likely to be obese than other groups.
Percentage of adults 18 to 64 who are overweight or obese, 2006
100
Overweight
80
60
55
54
40
31
32
20
Obese
69
24
22
32
49
28
37
21
0
Total
White
Black
Note: Obesity is defined as a Body Mass Index (BMI) of 30 kg/m 2 or more.
Overweight is defined as BMI of 25 to 29.9 kg/m 2.
Source: The Commonwealth Fund. Health Care Quality Survey. 2006.
Hispanic
29
24
5.0
Asian
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Chart 4-2. Hispanics are least likely of all racial/ethnic groups
to use a private doctor and most likely to use a
community health center as their usual place of care.
Percentage of adults ages 18 to 64 by usual place of care, 2006
100
80
White
77
Black
Hispanic
Asian
75
62*
60
44*
40
21*
20
9
12*
13
7
3
15
8
4
5
1
4
9
2
5
7
0
Doctor's office or
private clinic
Community
health center
Emergency
room
* Compared with whites, differences remain statistically significant after
adjusting for insurance or income.
Source: The Commonwealth Fund. Health Care Quality Survey. 2006.
No regular place
of care
Hospital
outpatient
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Chart 5-2. Nearly half of Hispanics report being uninsured
at some point in the past year.
Percentage of adults ages 18 to 64 uninsured
anytime in the past year, 2006
100
80
49 *
60
40
26
21
28
19
20
0
Total
White
Black
* Compared with whites, differences remain statistically significant after
adjusting for income.
Note: Data include adults uninsured at time of survey or insured at time of
survey but uninsured at some point in the previous year.
Source: The Commonwealth Fund. Health Care Quality Survey. 2006.
Hispanic
Asian
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Chart 6-7. Safety: Asian or Pacific Islander and Hispanic
nursing home residents are more likely to be
physically restrained than other racial/ethic groups.
Percentage of long-stay nursing home residents who were
physically restrained, by race/ethnicity, July–September 2004
20
15
10
10.6
9.5
8.0
7.3
7.2
Total
White, Non-
Black, Non-
Hispanic
Hispanic
6.4
5
0
Hispanic
AI/AN = American Indian/Alaska Native.
Source: Agency for Healthcare Research and Quality. National Healthcare
Disparities Report. 2006.
AI/AN
Asian/Pacific
Islander
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Chart 6-15. Effectiveness: Minorities are less likely to have
ever received a pneumococcal vaccination than whites.
Percentage of adults age 65 and over who have
ever had a pneumococcal vaccination, 2004
100
80
60
57
61
39
40
34
35
Hispanic
Asian
20
0
Total
White, non-
Black, non-
Hispanic
Hispanic
Note: Estimates are age adjusted to the 2000 U.S. standard population.
Source: Agency for Healthcare Research and Quality. National Healthcare
Disparities Report. 2006.
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Chart 7-9. Quality improvement efforts in dialysis care
are associated with improved quality overall and
smaller disparities between black and white patients.
Percentage of patients age 18 and over receiving
adequate hemodialysis dose, 1993–2000
100
80
60
40
62
46
36
53
54
70
63
73
69
76
70
85
87
83
84
White
Black
43
20
0
1993
1994
1995
1996
1997
Note: p<0.001.
Source: A. R. Sehgal, “Impact of Quality Improvement Efforts on Race and Sex
Disparities in Hemodialysis,” Journal of the American Medical Association, Feb.
26, 2003 289(8):996–1000.
1998
1999
2000
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Chart 7-5. Minorities with medical homes are just as likely
as whites to receive reminders for preventive care visits.
Percentage of adults ages 18 to 64 receiving a reminder
to schedule a preventive visit by doctor’s office
Medical home
Regular source of care, not a medical home
100
No regular source of care/ER
80
66
65
60
64
64
54
52
49
48
40
20
25
23
22
21
0
Total
White
Black
Note: Having a medical home includes having a regular provider or place of care,
reporting no difficulty contacting provider by phone, or getting advice and medical
care on weekends or evenings, and always or often finding office
visits well organized and running on time.
Source: The Commonwealth Fund. Health Care Quality Survey. 2006.
Hispanic
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