Abstract
IntroductionReducing racial health disparities is often stated as a population health goal, but specific targets for such improvement are seldom set. It is often assumed that improving overall health outcomes will be linked to disparity reduction, but this is not necessarily the case.MethodsWe compared the annual change from 1999 through 2013 in combined-race (black and white) mortality with the annual change in absolute and relative racial mortality disparities for US states.ResultsMedian annual improvement in combined-race mortality was 1.08% per year. Annual overall mortality rate reductions ranged from 0.24% per year in Oklahoma to 1.83% per year in Maryland. For disparities, the median for the black–white absolute gap was 3.60% per year, and the median for the relative black-to-white ratio was 1.19% per year. There was no significant correlation between the combined-race measure and either the absolute (0.03) or relative disparity measure reductions (−0.17).ConclusionFor mortality in US states over a recent period, improvement in the population mean and disparity reduction do not usually occur together. The disparity reduction rates observed may provide realistic guidance for public and private policy makers in setting goals for reducing population health disparity and creating investment priorities. As a starting point for discussion, the observed national median annual percentage improvement of 1.1 per year combined, 3.6% per year absolute gap reduction, and 1.2% per year relative gap reduction would be modest and reasonable goals.
Highlights
Reducing racial health disparities is often stated as a population health goal, but specific targets for such improvement are seldom set
National and state health outcome goals are often framed in terms of improving the population mean and reducing or eliminating disparities within the population
Another recent study found that large racial disparities in some states are explained by higher-than-average life expectancy among whites or lower-than-average life expectancy among blacks [10]
Summary
Reducing racial health disparities is often stated as a population health goal, but specific targets for such improvement are seldom set. National and state health outcome goals are often framed in terms of improving the population mean and reducing or eliminating disparities within the population. In Healthy People 2020, the 2 overarching goals are 1) attain high-quality, longer lives free of preventable disease, disability, injury, and premature death, and 2) achieve health equity, eliminate disparities, and improve the health of all groups [1]. As Keppel et al pointed out with regard to Healthy People 2010, the first goal does not necessarily achieve health equity, eliminate disparities, and improve the health of all groups [2]. Satcher et al showed that the black–white gap in mortality rates changed little between 1960 and 2000 [9] Another recent study found that large racial disparities in some states are explained by higher-than-average life expectancy among whites or lower-than-average life expectancy among blacks [10]. Webb et al constructed a health disparity index by race, which compared state performance but did not contrast disparity reduction with mean improvement [11]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
