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Improving Health Disparities Research

Howard K. Koh, M.D., M.P.H.
Assistant Secretary for Health
U.S. Department of Health and Human Services

November 3, 2011

This year we have achieved important milestones in our commitments to reduce racial and ethnic health disparities, including the release of Healthy People 2020 and the National Prevention Strategy, as well as the launch of the HHS Action Plan to Reduce Racial and Ethnic Health Disparities.

We achieved yet another milestone this week by implementing an important provision of the Affordable Care Act that will improve the collection of data on HHS-sponsored surveys. With this advance, we as a nation can better understand and target health disparities and ultimately move toward eliminating them.  

After reviewing the more than 400 public comments we received on draft standards proposed last June, we are now publishing final standards for data collection and reporting on race, ethnicity, sex, primary language and disability status. Previously, identifying and reducing disparities has been limited by a lack of uniformity, specificity, and quality in data collection and reporting.  Now, consistent methods for collecting and reporting health data will help us to better characterize and compare the nature of health problems in targeted populations. These new data standards, required by the Affordable Care Act, represent a powerful new set of tools to move us closer to our vision of a nation free of disparities in health and health care.

With respect to race and ethnicity, we can now collect more data on key groups. For example, by adding Mexican American and Chicano/a, Puerto Rican, Cuban, and Other Hispanic Latino/a or Spanish origin as explicit categories on all HHS-sponsored health surveys, we can better capture, understand and act upon the specific challenges presented by each ethnic group -- challenges that would otherwise be lost under broader terms, like “Hispanic” or “Latino.”  Such detail could possibly shed light on health problems such as initial studies that suggest the diabetes-related mortality rate for Mexican Americans and Puerto Ricans may be twice as high as that seen for Cuban Americans. 

With respect to disability and primary language, this announcement also breaks new ground. These first- ever uniform disability standards will ultimately improve researchers' abilities to monitor and track health disparities in this critical public health area. And, for the first time, we can collect in a standardized way, information of the primary language spoken by a person or in a household.

Separately, we are continuing to implement efforts that will ultimately allow integration of questions on lesbian, gay, bisexual and transgender (LGBT) health into national HHS data collection efforts.  Expanding data collection to include information on the health of the LGBT population is important to understanding and tackling disparities. 

The Department’s data collection efforts under these new standards will continue to ensure privacy protection and apply all appropriate information security safeguards in the collection, analysis, and sharing of data. 

All these advances collectively strengthen the critical information by which we, as a nation, identify and address disparities in the future. For more on the final data standards on race, ethnicity, sex, primary language  and disability status, please visit www.minorityhealth.hhs.gov/section4302