Abstract
Much research on the issue of health disparities in the United States has been produced by health services researchers across disciplines, particularly medical care providers, public health workers and sociologists. Many economists have also studied health disparities. This special issue of Atlantic Economic Journal highlights in particular the role of economic scholarship in this important national debate. This article, introducing the special issue, categorizes the contribution of many economists to the literature on health disparity. The literature reviewed ultimately includes 107 articles published between 1998 and 2008. Articles by any of the 932 economists that were members of the American Society of Health Economists in 2006 publishing about racial/ethnic health disparities as found in Medline, articles related to racial/ethnic health disparities published in Health Economics or the Journal of Health Economics or through searches in EconLit were reviewed for inclusion.
Similar content being viewed by others
References
Category: Conceptualizing and Measuring Disparity
Allison, R. A., & Foster, J. E. (2004). Measuring health inequality using qualitative data. Journal of Health Economics, 23, 505–524. doi:10.1016/j.jhealeco.2003.10.006.
Bilheimer, L. T., & Sisk, J. E. (2008). Collecting adequate data on racial and ethnic disparities in health: the challenges continue. Health Affairs, 27(2), 383–391. doi:10.1377/hlthaff.27.2.383.
Bleichrodt, H., & van Doorslaer, E. (2006). A welfare economics foundation for health inequality measurement. Journal of Health Economics, 25, 954–957. doi:10.1016/j.jhealeco.2006.01.002.
Cook, B. L. (2007). Effect of Medicaid managed care on racial disparities in health care access. Health Services Research, 42(1), 124–145. doi:10.1111/j.14756773.2006.00611x.
Cook, B. L., McGuire, T., & Miranda, J. (2007). Measuring trends in mental health care disparities, 2000-2004. Psychiatric Services (Washington, D.C.), 58(12), 1533–1540. doi:10.1176/appi.ps.58.12.1533.
Dutta, I. (2007). Health inequality and non-monotonicity of the health related social welfare function. Journal of Health Economics, 26, 414–421. doi:10.1016/j.jhealeco.2006.08.001.
Gaskin, D. J., & Frick, K. D. (2008). Race and ethnic disparities in valuing health. Medical Decision Making, 28, 12–20. doi:10.1177/0272989X07309641.
Gaskin, D. J., Arbelaz, J. J., Brown, J. R., Petras, H., Wagner, F. A., & Cooper, L. A. (2007). Examining racial and ethnic disparities in site of usual source of care. Journal of the National Medical Association, 99(1), 22–30.
Hebert, P. L., Frick, K. D., Kane, R. L., & McBean, A. M. (2005). The causes of racial and ethnic differences in influenza vaccination rates among elderly Medicare beneficiaries. Health Services Research, 40(2), 517–537. doi:10.1111/j.14756773.2005.0e371.x.
Hebert, P. L., Sisk, J. E., & Howell, E. A. (2008). When does a difference become a disparity? Conceptualizing racial and ethnic disparities in health. Health Affairs, 27(2), 374–382. doi:10.1377/hlthaff.27.2.374.
Herrod, H. G., & Chang, C. F. (2007). Potentially avoidable pediatric hospitalizations as defined by the Agency for Healthcare Research and Quality: what do they tell us about disparities in child health? Clinical Pediatrics, 20(10), 1–9.
Institute of Medicine. (2002). Unequal treatment: Confronting racial and ethnic disparities in healthcare. Washington, D.C.: National Academies Press.
Krieger, N., Chen, J. T., Waterman, P. D., Soobader, M.-J., Subramanian, S. V., & Carson, R. (2003). Choosing area based socioeconomic measures to monitor social inequalities in low birth weight and childhood lead poisoning: the public health disparities geocoding project (US). Journal of Epidemiology and Community Health, 57, 186–199. doi:10.1136/jech.57.3.186.
Mays, V. M., Ponce, N. A., Washington, D. L., & Cochran, S. D. (2003). Classification of race and ethnicity: implications for public health. Annual Review of Public Health, 24, 83–110.
Naga, R. H. A., & Yalcin, T. (2008). Inequality measurement for ordered response health data. Journal of Health Economics, 27, 1614–1625. doi:10.1016/j.jhealeco.2008.07.015.
Subramanian, S. V., Chen, J. T., Rehkoph, D. H., Waterman, P. D., & Krieger, N. (2006). Comparing individual and area-based socioeconomic measures for the surveillance of health disparities: a multilevel analysis of Massachusetts births 1989-1991. American Journal of Epidemiology, 164(9), 823–834. doi:10.1093/aje/kwj313.
Wagstaff, A. (2002). Inequality aversion, health inequalities and health achievement. Journal of Health Economics, 21, 627–641. doi:10.1016/S0167-6296(02)00006-1.
White-Means, S. I., & Rubin, R. M. (2004). Is there equity in the home health care market? Understanding racial patterns in the use of formal home health care. Journal of Gerontology, 59B(4), S220–S229.
Category: Documenting Differences in Disease Prevalence and Outcomes
Barnato, A. E., Alexander, S. L., Linde-Zwirble, W. T., & Angus, D. C. (2008). Racial variation in the incidence, care, and outcomes of severe sepsis: analysis of population, patient and hospital characteristics. American Journal of Respiratory and Critical Care Medicine, 17, 279–284.
Bian, J., Oddone, E. Z., Samsa, G. P., Lipscomb, J., & Matchar, D. B. (2003). Racial differences in survival post cerebral infarction among the elderly. Neurology, 60, 285–290.
Charbonneau, A., Rosen, A. K., Ash, A. S., Owen, R. R., Kader, B., Spiro, A., III, et al. (2003). Measuring the quality of depression care in a large intergrated health system. Medical Care, 42(5), 669–680. doi:10.1097/00005650-200305000-00014.
Cook, B. L., McGuire, T., & Miranda, J. (2007). Measuring trends in mental health care disparities, 2000-2004. Psychiatric Services (Washington, D.C.), 58(12), 1533–1540. doi:10.1176/appi.ps.58.12.1533.
Finkelstein, E. A., Khavjou, O. A., Mobley, L. R., Haney, D. M., & Will, J. C. (2004). Racial/ethnic disparities in coronary heart disease risk factors among (WISEWOMAN enrollees. Journal of Women's Health, 13(5), 503–518. doi:10.1089/1540999041280963.
Geronimus, A. T., Bound, J., Waidmann, T. A., Colen, C. G., & Steffick, D. (2001). Inequality in life expectancy, functional status, and active life expectancy across selected black and white populations in the United States. Demography, 38(2), 227–251. doi:10.1353/dem.2001.0015.
Giles, T., Aranda, J. M., Suh, D. C., Choi, I. S., Preblick, R., Rocha, R., et al. (2007). Ethnic/racial variations in blood pressure awareness, treatment, and control. Journal of Clinical Hypertension, 9(5), 345–354. doi:10.1111/j.1524-6175.2007.06432.x.
Halpern, M. T., Ward, E. M., Pavluck, A. L., Schrag, N. M., Bian, J., & Chen, A. Y. (2008). Association of insurance status and ethnicity with cancer stage at diagnosis for 12 cancer sites: a retrospective analysis. The Lancet Oncology, 9, 222–231. doi:10.1016/S1470-2045(08)70032-9.
Oliver, M. N., Stukenborg, G. J., Wagner, D. P., Harrell, F. E., Jr., Kilbridge, K. L., Lyman, J. A., et al. (2004). Co-morbid disease and the effect of race and ethnicity on in-hospital mortality from aspiration pneumonia. Journal of the National Medical Association, 96(11), 1462–1469.
Wong, M. D., Tagawa, T., Hsieh, H.-J., Shapiro, M. F., Boscardin, W. J., & Ettner, S. L. (2005). Difference in cause-specific mortality between Latino and white adults. Medical Care, 43(10), 1058–1062. doi:10.1097/01.mlr.0000178196.14532.40.
Category: Mechanisms that Potentially Lead to Health Disparities
Adimora, A. A., Schoenbach, V. J., Bonas, D. M., Martinson, F. E. A., Donaldson, K. H., & Stancil, T. R. (2002). Concurrent sexual partnerships among women in the United States. Epidemiology, 13(3), 320–327.
Asch, M., & Brandt, S. (2006). Disparities in asthma hospitalization in Massachusetts. American Journal of Public Health, 96(2), 358–362.
Balsa, A. I., & McGuire, T. G. (2001). Statistical discrimination in health care. Journal of Health Economics, 20, 881–907.
Balsa, A. I., & McGuire, T. G. (2003). Prejudice, clinical uncertainty and stereotyping as sources of health disparities. Journal of Health Economics, 22, 89–116.
Barnato, A. E., Lucas, F. L., Staiger, D., Wennberg, D. E., & Chandra, A. (2005). Hospital-level racial disparities in acute myocardial infarction treatment and outcomes. Medical Care, 43(4), 308–319.
Barnato, A. E., Berhane, Z., Weissfeld, L. A., Chang, C. H., Linde-Zwirble, W. T., & Angus, D. C. (2006). Racial variation in end-of-life intensive care use: a race or hospital effect? Health Services Research, 41(6), 2219–2237.
Barnato, A. E., Chang, C. H., Saynina, O., & Garber, A. M. (2007). Influence of race on inpatient treatment intensity at the end of life. Journal of General Internal Medicine, 22, 338–345.
Basu, J. (2005). Severity of illness, race, and choice of local versus distant hospitals among the elderly. Journal of Health Care for the Poor and Underserved, 16, 391–405.
Basu, J., & Friedman, B. (2007). A re-examination of distance as a proxy for severity of illness and the implications for differences in utilization by race/ethnicity. Health Economics, 16, 687–701.
Boyce, J. K., Klemer, A. R., Templet, P. H., & Willis, C. E. (1999). Power distribution, the environment, and public health: a state-level analysis. Ecological Economics, 29, 127–140.
Charbonneau, A., Rosen, A. K., Ash, A. S., Owen, R. R., Kader, B., Spiro, A., III, et al. (2003). Measuring the quality of depression care in a large intergrated health system. Medical Care, 42(5), 669–680. doi:10.1097/00005650-200305000-00014.
Clemens-Cope, L., & Kenney, G. (2007). Low income parents’ reports of communication problems with health care providers: effects of language and insurance. Public Health Reports, 122, 206–216.
Do, P. D., Dubowitz, T., Bird, C. E., Lurie, N., Escarce, J. J., & Finch, B. K. (2007). Neighborhood context and ethnicity differences in body mass index: a multilevel analysis using the NHANES III survey. Economics and Human Biology, 5, 197–203.
Du, X. L., Fang, S., Vernon, S. W., El-Serag, H., Shih, Y. T., Davila, J., & Rasmus, M.L. (2007). Racial disparities and socioeconomic status in association with survival in a large population-based cohort of elderly patients with colon cancer. Cancer, 110(3), 660–669.
Dynan, L. (2008). A micro-simulation based decomposition of the health status gap between US blacks and whites. New York Economic Review, 39, 3–27.
Gaskin, D. J., & Hoffman, C. (2000). Racial and ethnic differences in preventable hospitalization across 10 states. Medical Care Research and Review, 57(S1), 85–107.
Gaskin, D. J., Arbelaz, J. J., Brown, J. R., Petras, H., Wagner, F. A., & Cooper, L. A. (2007). Examining racial and ethnic disparities in site of usual source of care. Journal of the National Medical Association, 99(1), 22–30.
Grabowski, D. C. (2004). The admission of blacks to high-deficiency nursing homes. Medical Care, 42(5), 456–464.
Grann, V., Troxel, A. B., Zojwalla, N., Hershman, D., Glied, S. A., & Jacobson, J. S. (2006). Regional and racial disparities in breast cancer-specific mortality. Social Science and Medicine, 62, 337–347.
Gregory, P. C., Han, E., Morozova, O., & Kuhlemeier, K. (2006). Do racial disparities exist in access to inpatient stroke rehabilitation in the state of Maryland? American Journal of Physical Medicine & Rehabilitation, 85(10), 814–819.
Groeneveld, P. W., Heidenreich, P. A., & Garber, A. M. (2005). Trends in implantable cardioverter-defibrillator racial disparity. Journal of the American College of Cardiology, 45(1), 72–78.
Groenveld, P. W., Laufer, S. B., & Garber, A. M. (2005). Technology diffusion, hospital variation, and racial disparities among elderly Medicare beneficiaries 1989–2000. Medical Care, 43(4), 320–329.
Gurmankin, A. D., Polsky, D., & Volpp, K. G. (2004). Accounting for apparent ‘reverse’ racial disparities in Department of Veterans Affairs (VA)-based medical care: Influence of out–of-VA care. American Journal of Public Health, 94(120), 2076–2078.
Haas, J., & Swartz, K. (2007). The relative importance of worker, firm, and market characteristics for racial/ethnic disparities in employer-sponsored health insurance. Inquiry, 44, 208–302.
Han, E., & Liu, G. G. (2005). Racial disparities in prescription drug use for mental illness among population in US. The Journal of Mental Health Policy and Economics, 8, 131–143.
Hebert, P. L., Frick, K. D., Kane, R. L., & McBean, A. M. (2005). The causes of racial and ethnic differences in influenza vaccination rates among elderly Medicare beneficiaries. Health Services Research, 40(2), 517–537. doi:10.1111/j.14756773.2005.0e371.
Heslin, K. C., Andersen, R. M., Ettner, S. L., & Cunningham, W. E. (2005). Racial and ethnic disparities in access to physicians with HIV-related expertise: findings from a nationally representative survey. Journal of General Internal Medicine, 20, 283–289.
Hoffman-Goetz, L., Breen, N. L., & Meissner, H. (1998). The impact of social class on the use of cancer screening within three racial/ethnic groups in the United States. Ethnicity and Disease, 8, 43–51.
Howard, D. H., Sentell, T., & Gazmararian, J. (2006). Impact of health literacy on socioeconomic and racial differences in health in an elderly population. Journal of General Internal Medicine, 21, 857–861.
Iribarren, C., Tolstykh, I., Somkin, C. P., Ackerson, L. M., Brown, T. T., Scheffler, R., et al. (2005). Sex and racial/ethnic disparities in outcomes after acute myocardial infarction: a cohort study among members of a large integrated health care delivery system in Northern California. Archives of Internal Medicine, 165, 2105–2113.
Lees, K. A., Wortley, P. M., & Coughlin, S. S. (2005). Comparison of racial/ethnic disparities in adult immunizations and cancer screening. American Journal of Preventive Medicine, 29(5), 404–411.
Lorenz, K. A., Ettner, S. L., Rosenfeld, K. E., Carlisle, D., Lui, H., & Asch, S. M. (2004). Accommodating ethnic diversity: a study of California hospice programs. Medical Care, 42(9), 871–874.
McGuire, T. G., & Miranda, J. (2008). New evidence regarding racial and ethnic disparities in mental health: policy implications. Health Affairs, 27(2), 393–403.
Miller, D. L., & Paxson, C. (2006). Relative income, race, and mortality. Journal of Health Economics, 25, 979–1003.
Monheit, A. C., & Vistnes, J. P. (2000). Race/ethnicity and health insurance status: 1987 and 1996. Medical Care Research and Review, 57(S1), 11–35.
Morales, L. S., Satiger, D., Horbar, J. D., Carpenter, J., Kenny, M., Geppert, J., et al. (2005). Mortality among very low-birthweight infants in hospitals serving minority populations. American Journal of Public Health, 95(12), 2206–2212.
Mukamel, D. B., Weimer, D. L., & Mushlin, A. I. (2006). Referrals to high-quality cardiac surgeons: patients’ race and characteristics of their physicians. Health Services Research, 41(4), 1276–1295. Part 1.
Mukamel, D., Glance, L., Weimer, D., Pearson, T., Massey, T., Gold, J., et al. (2007). Racial variations in the choice of on-pump versus off-pump coronary artery bypass grafting. Journal of Health Services Research and Policy, 12(1), 31–35.
Nelson, T. F., Gortmaker, S. L., Subramanian, S. V., & Wechsler, H. (2007). Vigorous physical activity among college students in the United States. Journal of Physical Activity and Health, 4, 495–508.
Ponce, N. A., Huh, S., & Bastani, R. (2005). Do HMO market level factors lead to racial/ethnic disparities in colorectal cancer screening?: A comparison between high-risk Asian and Pacific Islander Americans and high-risk whites. Medical Care, 43(11), 1101–1108.
Ponce, N. A., Cochran, S. D., Mays, V. M., Chia, J., & Brown, E. R. (2008). Health coverage of low-income citizen and noncitizen wage earners: sources and disparities. Journal of Immigrant and Minority Health, 10, 167–176.
Powell, L. M., Slater, S., Chaloupka, F. J., & Harper, D. (2006). Availability of physical activity-related facilities and neighborhood demographic and socioeconomic characteristics: a national study. American Journal of Public Health, 96(9), 1676–1680.
Pylypchuk, Y., & Seldon, T. M. (2008). A discrete choice decomposition analysis of racial and ethnic differences in children’s health insurance coverage. Journal of Health Economics, 27, 1109–1128.
Ray, G. T., Levine, P., Croen, L. A., Bokhari, F. A. S., Hu, T.-W., & Habel, L. A. (2006). Attention deficit/hyperactivity disorder in children: excess costs before and after initial diagnosis and treatment cost differences by ethnicity. Archives of Pediatric Adolescent Medicine, 160, 1063–1069.
Reschovsky, J. D., & O’Malley, A. S. (2008). Do primary care physicians treating minority patients report problems delivering high-quality care? Health Affairs, 26(3), w222–w231.
Rice, T. (2003). The impact of cost containment efforts on racial and ethnic disparities in healthcare: a conceptualization. In Unequal Treatment, IOM: 699-721.
Rothenberg, B. M., Pearson, T., Zwanziger, J., & Mukamel, D. (2004). Explaining disparities in access to high-quality cardiac surgeons. Annals of Thoracic Surgery, 78, 18–25.
Sehili, S., Elbasha, E. H., Moriarty, D. G., & Zack, M. M. (2005). Inequalities in self-reported physical health in the United States, 1993–1999. Health Economics, 14, 377–389.
Shavers, V. L., Brown, M., Klabunde, C. N., Potosky, A. P., Davis, W., Moul, J., et al. (2004). Race/ethnicity and the intensity of medical monitoring under ‘watchful waiting’ for prostate cancer. Medical Care, 42(3), 239–250.
Swan, J., Breen, N., Coates, R. J., Rimer, B. K., & Lee, N. C. (2003). Progress in cancer screening practices in the United States. Cancer, 97(6), 1528–1540.
Viswanath, K., Breen, N., Meissner, H., Moser, R. P., Hesse, B., Steele, W. R., et al. (2006). Cancer knowledge and disparities in the information age. Journal of Health Communication, 11, 1–17.
Waidmann, T. A., & Rajan, S. (2000). Race and ethnic disparities in health care access and utilization: an examination of state variation. Medical Care Research and Review, 57(Supp 1), 55–84.
Weinick, R. M., Zuvekas, S. H., & Cohen, J. W. (2000). Racial and ethnic differences in access to and use of health care services, 1977 to 1996. Medical Care Research and Review, 57(Supp.1), 36–54.
Werner, R. M., Asch, D. A., & Polsky, D. (2005). Racial profiling: the unintended consequences of coronary artery bypass graft report cards. Circulation, 111, 1257–1263.
Wisnivesky, J. P., McGinn, T., Henschke, C., Hebert, P., Iannuzzi, M. C., & Halm, E. A. (2005). Ethnic disparities in the treatment of stage 1 non-small cell lung cancer. American Journal of Respiratory Critical Care, 171, 1158–1163.
Category: How Disparity Impacts Other Outcomes
Bastida, E., & Pagan, J. A. (2002). The impact of diabetes on adult employment and earnings of Mexican Americans: findings from a community based study. Health Economics, 11, 403–413.
Chatterji, P., Alegria, M., Lu, M., & Takeuchi, D. (2007). Psychiatric disorders and labor market outcomes: evidence from the national Latino and Asian American study. Health Economics, 16, 1069–1090.
Currie, J. (2005). Health disparities and gaps in school readiness. The Future of Children, 15(1), 117–138.
Category: Policy and Evaluation
Adams, E. K., Breen, N., & Joski, P. J. (2007). Impact of the National Breast and Cervical Cancer Early Detection Program on mammography and pap test utilization among white, Hispanic, and African- American women: 1996–2000. Cancer Supplement, 108(2), 348–358.
Armour, B. S., Friedman, C., Pitts, M., Wike, J., Alley, L., & Etchason, J. (2004). The influence of year-end bonuses on colorectal cancer screening. American Journal of Managed Care, 10(9), 617–624.
Balsa, A. I., Cao, Z., & Mcguire, T. G. (2007). Does managed health care reduce health care disparities between minorities and whites? Journal of Health Economics, 26, 101–121.
Basu, J., Friedman, B., & Burstin, H. (2006). Preventable hospitalization and Medicaid managed care: does race matter? Journal of Health Care for the Poor and Underserved, 17, 101–115.
Bazzoli, G. J., Kang, R., Hasnain-Wynia, R., & Lindrooth, R. C. (2005). An update on safety-net hospitals: coping with the late 1990s and early 2000s. Health Affairs, 24(4), 1047–1055.
Chien, A. T., Chin, M. H., Davis, A. M., & Casalino, L. P. (2007). Pay for performance, public reporting and racial disparities in health care: how are programs being designed? Medical Care Research and Review, 64(5S), 283S–304S.
Cook, B. L. (2007). Effect of Medicaid managed care on racial disparities in health care access. Health Services Research, 42(1), 124–145. doi:10.1111/j.14756773.2006.00611x.
Currie, J., Decker, S., & Lin, W. (2008). Has public insurance for older children reduced disparities in access to care and health outcomes? Journal of Health Economics, 27, 1567–1581.
Duru, O. K., Mangione, C. M., Steers, N. W., Herman, W. H., Karter, A. J., Kountz, D., et al. (2006). The association between clinical care strategies and the attenuation of racial/ethnic disparities in diabetes care: the translating research into action for diabetes (TRIAD) study. Medical Care, 44(12), 1121–1127.
Dynan, L. (2007). The impact of medical education reform on the racial health status gap, 1920–1930: A difference-in differences analysis. Review of Black Political Economy, 34(3–4), 245–258.
Lurie, I. Z. (2008). Welfare reform and the decline in the health-insurance coverage of children of non-permanent residents. Journal of Health Economics, 27, 786–793.
Miranda, J., Duan, N., Sherbourne, C., Shoenbaum, M., Lagomasino, I., Jackson-Triche, M., et al. (2003). Improving care for minorities: can quality improvement interventions improve care and outcomes for depressed minorities? Results of a randomized controlled trial. Health Services Research, 38(2), 613–630.
Mukamel, D. B., Weimer, D. L., Zwanzinger, Z., Gorthy, S.-F. H., & Mushlin, A. I. (2004). Quality report cards, selection of cardiac surgeons, and racial disparities: a study of the publication of the New York state cardiac surgery reports. Inquiry, 41, 435–446.
Rice, T. (2003). The impact of cost containment efforts on racial and ethnic disparities in healthcare: a conceptualization. In Unequal Treatment, IOM: 699-721.
Rumsfeld, J. S., & Epstein, A. J. (2006). Racial disparities in cardiovascular procedure outcomes: turn down the volume. Journal of the American College of Cardiology, 47(2), 425–426.
Shih, Y.-C. T., Zhao, L., & Elting, L. S. (2006). Does Medicare coverage of colonoscopy reduce racial/ethnic disparities in cancer screening among the elderly? Health Affairs, 25(4), 1153–1162.
Tai-Seale, M., Freund, D., & LoSasso, A. (2001). Racial disparities in service use among Medicaid beneficiaries after mandatory enrollment in managed care: a difference in differences approach. Inquiry, 38, 45–59.
van Voorhees, B. W., Walters, A. E., Prochaska, M., & Quinn, M. T. (2007). Reducing health disparities in depressive disorders outcomes between non-Hispanic whites and ethnic minorities: a call for pragmatic strategies over the life course. Medical Care Research and Review, 64(5-supplement), 157S–194S.
Zuckerman, S., Bazzoli, G., Davidoff, A., & LoSasso, A. (2001). How did safety-net hospitals cope in the 1990s? Health Affairs, 20(4), 159–168.
Author information
Authors and Affiliations
Corresponding author
Additional information
Thanks to Jamie Jaspers for able research assistance.
Rights and permissions
About this article
Cite this article
Dynan, L. The Contribution of Economists to Understanding Racial Health Disparities in the US. Atl Econ J 37, 213–223 (2009). https://doi.org/10.1007/s11293-009-9180-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11293-009-9180-z