Descriptive Analysis of the 2014 Race-Based Healthcare Disparities Measurement Literature
There are more than 500 articles in the 2014 race-based healthcare disparities literature across a broad array of diseases and outcomes. However, unlike many other forms of research (e.g., clinical trials and systematic reviews), there are no required reporting guidelines when submitting results of disparities studies to journals.
This study describes the race-based healthcare disparities measurement literature in terms of study design, journal characteristics, generation of health disparities research, type of disparity measure used, and adherence to disparities measurement guidelines.
We searched three databases of peer-reviewed literature, PubMed, Ovid Medline, and JSTOR, for English language articles published in 2014 on racial/ethnic healthcare disparities. Studies must have quantitatively measured the difference in health outcomes between two racial/ethnic groups in order to be included. Our final sample included 266 studies from 167 medical and public health journals.
Only 7 % (n = 19) of articles reported both an absolute and relative measure of disparity; the majority of studies (64 %, n = 171) reported only a relative measure of effect. Most studies were published in clinical journals (74 %, n = 198), used secondary data (86 %, n = 229), and calculated black-white disparities (82 %, n = 218). The most common condition studied was cancer (25 %, n = 67), followed by a surgical procedure (18 %, n = 48). On average, articles in the sample only met 61 % of the applicable guidelines on reporting of disparities.
Conclusions and Relevance
To be able to synthesize findings in the racial disparities literature (meta-analysis), there is a need for the use of consistent methods for quantifying disparities and reporting in the literature. A more consistent battery of measures and consistent reporting across studies may help speed our understanding of the origins and development of solutions to address healthcare disparities. Despite guidelines for best practices in reporting disparities, there is a lack of adherence in the current literature.
KeywordsRacial health disparities Systematic review Literature review Descriptive analysis Methods Measures
The authors would like to thank Laura Harrison and Laura Santangelo for their preliminary review of articles and development of the database including extraction of key variables.
Compliance with Ethical Standards
The work of Dr. Goodman is supported by the Barnes-Jewish Hospital Foundation, Siteman Cancer Center, National Institutes of Health, National Cancer Institute grant U54CA153460 and Washington University School of Medicine Faculty Diversity Scholars Program. Dr. Gilbert is supported by the Robert Wood Johnson Foundation New Connections grant and the Saint Louis University Faculty Research Leave Program. Dr. Colditz is supported by an American Cancer Society Clinical Research Professorship and the Barnes-Jewish Hospital Foundation. The funding agreements ensured the authors’ independence in designing and conducting the study; collecting, analyzing, and interpreting the data; and preparation of the manuscript reporting the results.
Conflict of Interest
The authors have no conflicts of interest to declare.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human participants or animals performed by any of the authors.
- 1.Du Bois WEB, Eaton I. The Philadelphia negro: a social study. Published for the University; 1899.Google Scholar
- 2.Du Bois WEB. The Health and Physique of the Negro American: Report of a Social Study Made Under the Direction of Atlanta University, Together with the Proceedings of the Eleventh Conference for the Study of the Negro Problems, Held at Atlanta University, on May the 29. Octagon Press; 1906.Google Scholar
- 3.Institute of Medicine. Unequal treatment: confronting racial and ethnic disparities in health care. vol. 1. National Academy Press; 2003.Google Scholar
- 4.Heckler M. Report of the Secretary’s Task Force on Black & Minority Health. vol. 2. US Department of Health and Human Services; 1985.Google Scholar
- 5.Haynes MA, Smedley BD. The unequal burden of cancer: an assessment of NIH research and programs for ethnic minorities and the medically underserved: National Academies Press; 1999.Google Scholar
- 11.Moher D, Liberati A, Tetzlaff J, Altman D. PRISMA 2009 Checklist. 2009. doi: 10.1371/journal.pmed1000097.
- 13.Keppel K, Pamuk E, Lynch J, Carter-Pokras O, Kim I, Mays V, et al. Methodological issues in measuring health disparities. Vital Heal Stat Ser 2 Data Eval Methods Res 2005:1–16.Google Scholar
- 15.Harper S, Lynch J. Methods for measuring cancer disparities: using data relevant to healthy people 2010 Cancer-Related Objectives. 2010.Google Scholar
- 16.Harper S, Lynch J, Meersman SC, Breen N, Davis WW, Reichman ME. An overview of methods for monitoring social disparities in cancer with an example using trends in lung cancer incidence by area-socioeconomic position and race-ethnicity, 1992-2004. Am J Epidemiol. 2008;167:889–99.CrossRefPubMedPubMedCentralGoogle Scholar