Chartbook on Health Care for Blacks

Goals of the Chartbook on Health Care for Blacks

• Commemorates the 30th Anniversary of the Report of the Secretary's Task Force on Black and Minority Health (Heckler Report)
• Highlights progress for Blacks on priorities of the Heckler Report
• Summarizes trends in health care disparities by race related to:
  • Access to health care.
  • Priorities of the National Quality Strategy (NQS).

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Organization of the Chartbook on Health Care for Blacks

• Part of a series related to the National Healthcare Quality and Disparities Report (QDR).
• Organized into three parts:
  • Overviews of the QDR and the Black population, one of AHRQ’s priority populations.
  • Summary of trends in health care for the Black population related to priorities of the Heckler Report.
  • Summary of trends in health care for the Black population related to access to health care and NQS priorities.

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Terminology

Race

• For the sake of brevity, Blacks refers both to African Americans (U.S. born) and foreign-born Blacks.
• Foreign-born Blacks represent a growing percentage of the population but most data sources do not distinguish between U.S.- and foreign-born Blacks.
• In 2000 and later U.S. Census Bureau surveys:
• U.S.-born Blacks refer to people born in the United States, Puerto Rico, or other U.S. territories and those born abroad to at least one parent who is a U.S. citizen.
• Foreign-born Blacks refer to people born outside the United States, Puerto Rico, or other U.S. territories.
• Both terms refer to people whose race is Black or mixed Black, regardless of Hispanic origin.
• This terminology is used in 2000 and later U.S. Census Bureau surveys.

Source: American Community Survey and Puerto Rico Community Survey, 2013. 2013 Subject Definitions. http://www.census.gov/programs-surveys/acs/technical-documentation/code-lists.2013.html

Income

• The QDR's income data comes in two formats which is a determinant of the diverse sources of our data.
  • Poor, low income, middle income, and high income.
  • Quartiles: Q1- Q4.
• Poor is defined as having family income less than 100% of the Federal poverty level (FPL); low income refers to income of 100% to 199% of the FPL; middle income refers to income of 200% to 399% of the FPL; and high income refers to income of 400% of the FPL and above. These are based on U.S. census poverty thresholds for each data year, which are used for statistical purposes.
• Q1 represents the lowest income quartile and Q4 represents the highest income quartile based on the median income of a patient’s ZIP Code of residence.

Disparities

• Comparisons in this chartbook are between Blacks and Whites whenever the data are available.
• Some comparisons are between non-Hispanic Blacks and non-Hispanic Whites when those are the only data available; the terms "Blacks" and "Whites" are still used in these cases.

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Key Findings of the Chartbook on Health Care for Blacks

• Data on access to and quality of health care received by Blacks were available for almost all measures tracked in the QDR.
• Among Heckler Report priorities, disparities in colorectal cancer care and diabetes care presented major challenges for Blacks.
• Blacks have worse access to care although this is improving since the Affordable Care Act.
• Blacks receive poorer quality of care, especially on measures of as related to person centeredness and care coordination.

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