Olivia Carter-Pokras

ObjectivesThis report discusses six issues that affect the measurement of disparities in health between groups in a population: Selecting a reference point from which to measure disparityMeasuring disparity in absolute or in relative termsMeasuring in terms of favorable or adverse eventsMeasuring in pair-wise or in summary fashionChoosing whether to weight groups according to group sizeDeciding whether to consider any inherent ordering of the groups. These issues represent choices that are made when disparities are measured.MethodsExamples are used to highlight how these choices affect specific measures of disparity.ResultsThese choices can affect the size and direction of disparities measured at a point in time and conclusions about the size and direction of changes in disparity over time. Eleven guidelines for measuring disparities are presented.ConclusionsChoices concerning the measurement of disparity should be made deliberately, recognizing that each choice will affect the results. When results are presented, the choices on which the measurements are based should be described clearly and justified appropriately.

This report discusses six issues that affect the measurement of disparities in health between groups in a population: Selecting a reference point from which to measure disparity. Measuring disparity in absolute or in relative terms. Measuring in terms of favorable or adverse events. Measuring in pair-wise or in summary fashion. Choosing whether to weight groups according to group size. Deciding whether to consider any inherent ordering of the groups. These issues represent choices that are made when disparities are measured. Examples are used to highlight how these choices affect specific measures of disparity. These choices can affect the size and direction of disparities measured at a point in time and conclusions about the size and direction of changes in disparity over time. Eleven guidelines for measuring disparities are presented. Choices concerning the measurement of disparity should be made deliberately, recognizing that each choice will affect the results. When results are ...

This study seeks the unique perspective of Latin-American-trained nurses on barriers and strategies to improve the health of Baltimore's Latino community. Individual in-depth interviews are conducted in Spanish with one male and seven female nurses recruited by Baltimore's Latino Providers Network. Audiotaped home interview transcripts are manually reviewed for common themes. Strategies include professional medical interpreters, workshops on the U.S. health care system, media campaign on affordable/bilingual care sources, licensing foreign-trained nurses, and outreach clinics linked to trusted community-based organizations. Findings can be used to develop culturally appropriate programs to better administer health care to Latino communities.

Challenges to recruitment of Latinos in health research may include language, cultural and communication barriers, trust issues, heterogeneity of legal status, and a high percent of uninsured when compared to the US population. This paper highlights the community-based participatory research (CBPR) process and expands on the applicability of these principles to Latino communities. We review steps taken and describe lessons learned in using a participatory approach to broadly assess and address the health of urban-dwelling Latinos in Baltimore, Maryland, through the adaptation of CBPR principles. We identified health priorities, access barriers, and community resources (eg, Latin American trained nurses who were not currently working in the health field, immigrant networks) using a participatory approach. Suggestions for improving trust, research participation, and access to care ranged from not collecting data on legal status, and regular attendance and presentations of ongoing rese...

To compare hypertension-related mortality (HRM) age-standardized and age-specific rates for Hispanic subgroup and non-Hispanic White (NHW) women; to identify underlying causes of HRM by Hispanic subgroup and age; and to examine relative percent change in HRM among Hispanic subgroups and NHW women. Secondary data analyses of 1995-1996 and 2001-2002 national vital statistics multiple cause mortality files. United States-50 states and District of Columbia. Mexican American (MA), Puerto Rican (PR), Cuban (CA) and NHW female decedents ages > or =45 years with hypertension listed as one of up to 20 conditions resulting in death. Age-standardized death rates (ASDR per 100,000) for HRM and relative percent change to examine trends (2-year intervals). During 1995-1996, the ASDR (per 100,000) for HRM was highest among PR (248.5) followed by NHW (188.7), MA (185.4), and CA women (139.7). During 2001-2002, PR (215.5) and MA (205.5) had higher ASDR for HRM than NHW (171.9) and CA women (104.6...