Data and measurement issues in the analysis of health disparities.
OBJECTIVE
To describe measurement challenges and strategies in identifying and analyzing health disparities and inequities.


METHODS
We discuss the limitations of existing data sources for measuring health disparities and inequities, describe current strategies to address those limitations, and explore the potential of emerging strategies.


RESULTS
Larger national sample sizes are necessary to identify disparities for major population subgroups. Collecting self-reported race and granular ethnicity data may reduce some measurement errors, but it raises other methodological questions. The assessment of health inequities presents particular challenges, requiring analysis of the interactive effects of multiple determinants of health. Indirect estimation and modeling methods are likely to be important tools for estimating health disparities and inequities for the foreseeable future.


CONCLUSIONS
Interdisciplinary training and collaborative research models will be essential for future disparities research. Evaluation of evolving methodologies for assessing health disparities should be a priority for health services researchers in the next decade.
Office of Analysis and Epidemiology, Centers for Disease Control and Prevention, National Center for Health Statistics, 3311 Toledo Rd, Hyattsville, MD 20782, USA. lbilheimer@cdc.gov
Linda T
LT
Bilheimer
Richard J
RJ
Klein
D015982:Bias; D003627:Data Interpretation, Statistical; D003710:Demography; D005006:Ethnicity / Q000706:statistics & numerical data; D006302:Health Services Research / Q000379:methods / Q000706:statistics & numerical data; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D044469:Racial Groups / Q000706:statistics & numerical data; D018401:Sample Size; D013223:Statistics as Topic / Q000379:methods; D014481:United States