title: An approach to studying social disparities in health and health care.
abstract: OBJECTIVE
  We explored methods and potential applications of a systematic approach to studying and monitoring social disparities in health and health care.
  
  
  METHODS
  Using delayed or no prenatal care as an example indicator, we (1) categorized women into groups with different levels of underlying social advantage; (2) described and graphically displayed rates of the indicator and relative group size for each social group; (3) identified and measured disparities, calculating relative risks and rate differences to compare each group with its a priori most-advantaged counterpart; (4) examined changes in rates and disparities over time; and (5) conducted multivariate analyses for the overall sample and "at-risk" groups to identify particular factors warranting attention.
  
  
  RESULTS
  We identified at-risk groups and relevant factors and suggest ways to direct efforts for reducing prenatal care disparities.
  
  
  CONCLUSIONS
  This systematic approach should be useful for studying and monitoring disparities in other indicators of health and health care.
authors.affiliation: Center on Social Disparities in Health, Department of Family and Community Medicine, University of California, San Francisco, CA 94143-0900, USA. braveman@fcm.uscf.edu
authors.forename: Paula A
authors.initials: PA
authors.lastname: Braveman
authors.forename: Susan A
authors.initials: SA
authors.lastname: Egerter
authors.forename: Catherine
authors.initials: C
authors.lastname: Cubbin
authors.forename: Kristen S
authors.initials: KS
authors.lastname: Marchi
mesh_terms: D002140:California; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006302:Health Services Research; D006801:Humans; D011247:Pregnancy; D011295:Prenatal Care; D011787:Quality of Health Care; D044469:Racial Groups; D012959:Socioeconomic Factors