title: Can States Simultaneously Improve Health Outcomes and Reduce Health Outcome Disparities?
abstract: Reducing racial health disparities is often stated as a population health goal, but specific targets for such improvement are seldom set. It is often assumed that improving overall health outcomes will be linked to disparity reduction, but this is not necessarily the case.
  
  
  
  We compared the annual change from 1999 through 2013 in combined-race (black and white) mortality with the annual change in absolute and relative racial mortality disparities for US states.
  
  
  
  Median annual improvement in combined-race mortality was 1.08% per year. Annual overall mortality rate reductions ranged from 0.24% per year in Oklahoma to 1.83% per year in Maryland. For disparities, the median for the black-white absolute gap was 3.60% per year, and the median for the relative black-to-white ratio was 1.19% per year. There was no significant correlation between the combined-race measure and either the absolute (0.03) or relative disparity measure reductions (-0.17).
  
  
  
  For mortality in US states over a recent period, improvement in the population mean and disparity reduction do not usually occur together. The disparity reduction rates observed may provide realistic guidance for public and private policy makers in setting goals for reducing population health disparity and creating investment priorities. As a starting point for discussion, the observed national median annual percentage improvement of 1.1 per year combined, 3.6% per year absolute gap reduction, and 1.2% per year relative gap reduction would be modest and reasonable goals.
authors: University of Wisconsin-Madison, Population Health Institute, 610 Walnut St, 550 WARF, Madison, WI 53726. Email: dakindig@wisc.edu.
authors: David
authors: D
authors: Kindig
authors: University of Wisconsin-Madison, Population Health Institute, Madison, Wisconsin.
authors: Nicholas
authors: N
authors: Lardinois
authors: Division of General Pediatrics and Adolescent Health, University of Minnesota School of Medicine, Minneapolis, Minnesota.
authors: Debanjana
authors: D
authors: Chatterjee
mesh_terms: D000367:Age Factors; D044383:Black People / Q000706:statistics & numerical data*; D016208:Databases, Factual; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008017:Life Expectancy / Q000639:trends; D008297:Male; D009026:Mortality; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*; D001741:Black or African American