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For more than 20 years, research has documented the persistent gaps in health care quality that disproportionately affect Americans from specific racial and ethnic backgrounds. These differences persist even when patients share the same health coverage and income status.

Below are some facts related to the quality and access to care Americans receive. These facts demonstrate the unacceptable problem of racial and ethnic disparities in health care. While the causes are complex—and, in some cases, still being studied—a comprehensive, multilevel strategy involving everyone in the health care delivery system is needed to solve the problem.

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Quality of Care

Blacks are 16 percent more likely to receive poorer quality care than Whites.

The Agency for Healthcare Research and Quality. (2006) 2006 National Health Quality and National Healthcare Disparities reports.


Hispanics are 20 percent more likely to receive poorer quality care than non-Hispanic Whites.

The Agency for Healthcare Research and Quality. (2006) 2006 National Health Quality and National Healthcare Disparities reports.


The proportion of obese adults who were told by a doctor or health professional that they were overweight was significantly lower among Blacks and Mexican Americans compared with Whites.

The Agency for Healthcare Research and Quality. (2006) 2006 National Health Quality and National Healthcare Disparities reports.


In 2001, 2002, and 2003, the proportion of adults age 40 and over with diabetes who received three recommended services was significantly lower among Hispanics compared with non-Hispanic Whites.

The Agency for Healthcare Research and Quality. (2006) 2006 National Health Quality and National Healthcare Disparities reports.


Clinical performance on HEDIS outcome measures was 6.8 to 14.4 percent lower for black enrollees than for white enrollees. For each measure, more than 70 percent of this disparity was due to different outcomes for black and white individuals enrolled in the same health plan rather than selection of black enrollees into lower-performing plans.

Trivedi, et al. (2006) Relationship Between Quality of Care and Racial Disparities Medicare Health Plans. Journal of the American Medical Association 296:1935-2004.


Sixty-five percent of whites report being “very satisfied” with the quality of their health care in the past two years, compared to 61 percent of African Americans, 56 percent of Hispanics and 45 percent of Asian Americans.

Princeton Survey Research Associates. (2001) The Commonwealth Fund 2001 Health Care Quality Survey.

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Access to Care

Blacks are 15 percent more likely to have worse access to care than whites.

The Agency for Healthcare Research and Quality. (2006) 2006 National Health Quality and National Healthcare Disparities reports.


Hispanics are 88 percent more likely to have worse access to care than non-Hispanic Whites.

The Agency for Healthcare Research and Quality. (2006) 2006 National Health Quality and National Healthcare Disparities reports.


In all years except 2001 and 2004, the proportion of persons with a specific source of ongoing care was significantly lower among Asians and Blacks compared with Whites.

The Agency for Healthcare Research and Quality. (2006) 2006 National Health Quality and National Healthcare Disparities reports.


From 1999 to 2003, the proportion of persons with insurance was significantly lower among Blacks compared with Whites, but in 2004 this disparity had been eliminated

The Agency for Healthcare Research and Quality. (2006) 2006 National Health Quality and National Healthcare Disparities reports.


From 1999 to 2004, rates of insurance decreased significantly for Whites, middle income persons, and persons of every education level, while rates increased significantly for Blacks and the poor.

The Agency for Healthcare Research and Quality. (2006) 2006 National Health Quality and National Healthcare Disparities reports.


Sixteen percent of whites report having no usual source of medical care, compared to 20 percent of African Americans and 30 percent of Hispanics.

Lillie-Blanton, et al. (2001) Site of medical care: Do racial and ethnic differences persist? Yale Journal of Health Policy, Law and Ethics 1(1):1-17.


Fifteen percent of white diabetes patients report having “very little” or “no choice” about where to go for medical care, as opposed to 22 percent of African-American, 28 percent of Hispanic and 24 percent of Asian-American diabetes patients.

Princeton Survey Research Associates. (2001) The Commonwealth Fund 2001 Health Care Quality Survey.


Sixty-six percent of African-American adults identify a doctor’s office as their regular source of care, compared to 80 percent of whites.

Princeton Survey Research Associates. (2001) The Commonwealth Fund 2001 Health Care Quality Survey.

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Language Barriers

Nearly half—47 percent—of individuals with limited English proficiency reported that they do not have a usual source of care. An additional 47 percent of individuals reported having a usual source of care that offers language assistance. Only 6 percent with limited English proficiency have a usual source of care that does not offer language assistance.

The Agency for Healthcare Research and Quality. (2006) 2006 National Health Quality and National Healthcare Disparities reports.


Compared with Whites who speak English at home, the proportion of persons uninsured all year was significantly higher among Whites, Blacks, and Asians who speak some other language at home as well as Blacks who speak English at home.

The Agency for Healthcare Research and Quality. (2006) 2006 National Health Quality and National Healthcare Disparities reports.


Hispanics and individuals who mainly speak Spanish at home were more likely to report communication problems with nurses but not with doctors compared with non-Hispanic Whites and individuals who mainly speak English at home, respectively.

The Agency for Healthcare Research and Quality. (2006) 2006 National Health Quality and National Healthcare Disparities reports.


Nineteen percent of Spanish-speakers report having forgone needed health treatment due to a language barrier.

Wirthlin WorldWide. (2001) Hablamos Juntos; We Speak Together.


Ten percent of whites, compared to 13 percent of African Americans and 19 percent of Hispanics reported having questions that they did not ask at their last doctor visit.

Princeton Survey Research Associates. (2001) The Commonwealth Fund 2001 Health Care Quality Survey.

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