Recorded presentation

Suzanne E. Proctor, MSPH and Ken Keppel, PhD. Division of Health Promotion, National Center for Health Statistics/CDC, 3311 Toledo Road, Hyattsville, MD 20782, (301) 458-4186, SProctor@cdc.gov

Healthy People 2010’s second goal calls for the elimination of disparities among population subgroups in several domains, including race and ethnicity, gender, and socioeconomic status. The upcoming Healthy People 2010 Midcourse Review will assess progress toward this goal for 383 population-based objectives. Progress toward the elimination of disparities between individual population subgroups and trends in the overall disparity in each domain will be assessed.

This study previews the statistical measures and tests that will be used to assess disparities between individual population subgroups for the Midcourse Review. The disparities between race and ethnic subgroups for 17 Healthy People 2010 objectives related to health care access are examined. The absolute and percent difference between the rate for the “best” race and ethnic subgroup and each other subgroup is calculated for the most recent data year. The absolute difference is tested to determine whether it is (a) statistically significant and (b) equivalent (difference between subgroup rates is smaller than a pre-specified, tolerable amount).

Preliminary analyses indicate that statistically significant and non-equivalent differences exist between Hispanics and the “best” subgroup for 13 of the 17 measures examined. Equivalence was achieved for four childhood vaccination measures (Hepatitis B, Hib, MMR, and Polio). Non-Hispanic blacks had the most favorable rate of Pap smear screening and had equivalent rates of coverage for 3 of 5 childhood vaccination measures and 3 other access measures. However, statistically significant and non-equivalent differences between non-Hispanic blacks and whites were observed for three screening measures.

Learning Objectives:

• Understand how to apply statistical tests of difference and equivalence to health data to assess disparities.
• Interpret the four possible outcomes of statistical tests of difference and equivalence.
• Identify two limitations of the test of difference.
• Identify two limitations of the test of equivalence.

Keywords: Access to Health Care, Health Disparities

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation