Disparities in health outcomes, health determinants, and access to and quality of healthcare are an ongoing policy priority in the United States. Efforts such as the National Healthcare Disparities Report and a multitude of disease and condition-specific studies provide compelling evidence on the extent of national disparities by race, ethnicity, sex, and, to a lesser extent, by socio-economic status. This body of work shows that disparities exist across multiple domains (i.e., race, ethnicity, sex, socio-economic status) for a wide range of chronic conditions including cardiovascular diseases, respiratory diseases, diabetes, cancers, psychiatric disorders, and musculoskeletal conditions.
Although these disparities have been explored at the national level where federal data systems are available, there are no systems that provide local data on race/ethnic disparities with regard to domains such as health outcomes, health risk factors, health services, and socio-economic context. Good data on these domains in local communities would allow for the careful documentation of the evolution of chronic disease disparities and the estimation of the impact of adverse economic events, such as the current recession, and how well investments in public health and medical care are mitigating or preventing disparities.
IHME and Public Health – Seattle & King County received federal funds under the American Recovery and Reinvestment Act of 2009 to gather information that helps to test the viability of a novel surveillance system that would utilize hospital records, pharmacy records, household surveys, and physical examinations to better understand the disparities in health outcomes among subpopulations in the US. The Harvard School of Public Health and the Dartmouth Institute for Health Policy & Clinical Practice are collaborating to accomplish these goals.
The main goal of this project is to design and implement a cost-effective, population-based surveillance system that integrates multiple data sources to track disparities in chronic diseases within King County. This system will capture the complete spectrum of relevant information from socio-economic context and health risk factors to disease incidence and the resulting cascade of hospitalizations, outpatient visits, and use of and adherence to interventions.
The resulting data from this surveillance will provide a much more precise understanding of the enormous variation within race/ethnicity groups across geographic communities within the county. Improved information that addresses these challenges is essential to policymakers interested in targeting effective interventions – be they from a public health, medical, economic, or other perspective.
Instruments from this project are currently being developed and tested and will be provided after implementation.