Chapter 1. Introduction and Methods

In 1999, Congress directed the Agency for Healthcare Research and Quality (AHRQ) to produce an annual report, starting in 2003, to track "prevailing disparities in health care delivery as it relates to racial factors and socioeconomic factors in priority populations¹." Although the emphasis is on disparities related to race, ethnicity, and socioeconomic status (SES), this directive includes a charge to examine disparities in "priority populations"—groups with unique health care needs or issues that require special focus.

The first National Healthcare Disparities Report (NHDR) was a comprehensive national overview of disparities in health care among racial, ethnic, and socioeconomic groups in the general U.S. population and among priority populations. It was released in 2003 with its companion report, the National Healthcare Quality Report (NHQR); the reports emphasize the interdependence of efforts to measure and address quality and disparities in health care and are intended to be used as companion documents.

This second NHDR is built upon the 2003 report and continues to include a comprehensive national overview of disparities in America. In addition, in the 2004 report, a second critical goal of the report series is developed—tracking the Nation's progress towards the elimination of health care disparities. Additional years of data are added that begin to allow examination of changes in disparities over time.

Together, the 2004 NHDR and NHQR are designed to provide policymakers with a snapshot of the current status of disparities and quality in American health care and an assessment of how disparities and quality are changing over time. In addition, tools used to create these reports are available in the appendixes. Health care providers and payers may apply these tools to their own data to assess their performance relative to the national benchmarks included in the reports.

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