Update on the Health Disparities Literature

Health and health care are distributed unevenly in the United States, and under-represented minorities are likely to get less of both. In 2002, the Institute of Medicine published an authoritative research and policy document on this matter. Since release of that report, hundreds of publications have addressed racial or ethnic disparities in health and health care. This Update focuses on the literature from 2002 and 2003 addressing the lack of equity in adult health and health care in the United States.

We read the title of every article published in leading medical, health services research, and health sociology journals in 2002 and 2003, including Annals of Internal Medicine, Journal of the American Medical Association, The New England Journal of Medicine, American Journal of Public Health, Health Services Research, Medical Care, Journal of Health and Social Behavior, Social Science and Medicine, and Sociology of Health and Illness. We selected this approach as a way to focus the review on articles with potentially high impact factors. On the basis of title, we reviewed the abstracts of 95 articles and then selected 20 for full independent evaluation by at least 2 authors. We excluded abstracts for the following reasons: The subject matter was thought to add only incrementally to the existing literature (n = 27), the scope of the subject matter was narrow (n = 24), the research did not focus on racial or ethnic disparities (n = 12), the focus of the article was theory or methodology (n = 10), the research was purely qualitative (n = 1), or the article was a review (n = 1).

Each reviewer rated the 20 articles reviewed in full on a scale of 1 to 10 on the following qualities: innovation, methodologic rigor, exposition, attention to new …