Key Facts on Health and Health Care by Race and Ethnicity

Introduction

Racial and ethnic disparities in health and health care remain a persistent challenge in the United States. Disparities not only result in inequities but also limit continued improvement in quality of care and population health and result in unnecessary health care costs. Many initiatives are underway to address disparities, and the Affordable Care Act (ACA) included provisions that advance efforts to reduce disparities. One key step to addressing disparities is identifying and documenting them. This information is necessary to develop and target interventions and to track progress over time. Data available to measure disparities is improving. Notably, the ACA requires all federal data collection efforts to obtain information on race, ethnicity, sex, primary language, and disability status. However, significant gaps in data persist, particularly for smaller population groups and racial and ethnic subgroups. These data gaps limit the ability to assess and address disparities and mask disparities among underlying subgroups.

This chart pack provides data on demographics; health coverage, access, and utilization; and health status by race and ethnicity to provide greater insight into the status of disparities. It examines changes in these measures by racial/ethnic group since the ACA coverage expansions were implemented in 2014, how these changes have affected disparities between groups of color and Whites, and how groups of color compare to Whites based on the most recent data available.1 Throughout the text, changes over time or differences between groups are only identified if they are statistically significant. Where data are available, this analysis examines measures by six racial/ethnic groups: White, Asian, Hispanic, Black, American Indian and Alaska Native (AIAN), and Native Hawaiian and Other Pacific Islander (NHOPI). Due to data limitations noted above, measures are not always available for all groups. The majority of measures are for the nonelderly population, but some measures include the total population or a specific subpopulation. Data are examined for 2013 (the year prior to implementation of the ACA coverage expansion) or the closest pre-ACA year available, and the most recent year available, which is generally 2017 or 2018. Years vary by measure and dataset (see Methods).

Endnotes

1 This analysis measures disparities in absolute terms—i.e., the simple difference between groups of color and Whites for each measure. Disparities may also be measured in relative terms by examining the percentage difference between measures for groups. Absolute and relative measures of disparities can provide differing results regarding changes in disparities over time. For more information see: Keppel, K., et al., (2005). Methodological issues in measuring health disparities. Vital and health statistics. Series 2, Data evaluation and methods research, (141), 1–16, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681823/.

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