Resource List - Methodologies for Measuring Health Disparities

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Methodological Issues in Measuring Health Disparities. 
National Center for Health Statistics. Keppel K, Pamuk E, Lynch J, et al. Vital Health Stat 2(141). 2005.
The report outlines six issues that should be considered when measuring health disparities: selection of a reference point from which to measure a disparity; measurement of disparity in absolute or relative terms; measurement of disparity in terms of favorable or adverse events; measurement of disparity in pair-wise fashion or summary measure; choosing to weight groups; and choosing to consider inherent ordering in groups.  These six issues can affect the size and direction of disparities being studied.  In response to the six issues, eleven guidelines are presented to measure disparities.  The choices made based on these guidelines should be discussed clearly in the methods of the study.

Using Race, Ethnicity and Language Data to Eliminate Health Disparities.  
California Pan-Ethnic Health Network. Policy Brief. June 2005.
This document lists several key recommendations for improving the collection and use of race, ethnicity and language data.  State agencies and commercial health plans do not do enough to collect, standardize, and share data.  The use of race and ethnicity data can help eliminate health disparities.  Key recommendations are: public and private health agencies must request the self-reporting of race, ethnicity and language information from clients; race, ethnicity and language categories should be standardized for data comparison; reporting categories should reflect the diversity of ethnic groups and subpopulations; race and ethnicity categories should include multi-racial and multi-ethnic individuals; health care providers should assess the diversity of their own workforce to determine the degree which the health care providers represent the community being served; and government agencies should develop strategies for sharing data.

Racial & Ethnic Disparities in Healthcare in California – California Fact Book.  
Office of Statewide Health Planning and Development.  November 2003.
This report features three sections presenting common and well-accepted measurements for assessing racial and ethnic healthcare disparities using data collected by OSHPD.  The first section describes Preventable Hospital Admission rates for conditions ranging from bacterial pneumonia to hypertension.  Rates are also adjusted for their estimated prevalence within different population groups.  The second section presents Mortality Following Hospitalization for three conditions: acute myocardial infarction, community-acquired pneumonia, and coronary artery bypass graft surgery.  The third section portrays data on the Use of Invasive Cardiovascular Procedures among patients admitted with a diagnosis of either acute myocardial infarction or unstable angina.

A Procedure to Characterize Geographic Distributions of Rare Disorders in Cohorts (UCD Authors)
This study focused on improved techniques for finding statistical significance for clusters of individual point data.  By eliminating false positives (which would incorrectly correlate individual data points as significant clusters), resultant clusters can thus be analyzed for demographic risk factors because confounding evidence is significantly reduced.