Written by Darrell J. Gaskin and Thomas A. LaVeist

On April 10, 2015, the Agency for Healthcare Research and Quality (AHRQ) released the latest version of the National Quality and Disparities Report, a Congressionally-mandated report that uses more than 40 national data sources and more than 250 measures to describe annual trends in access, quality, and disparities in health care.

There is clearly some good news. Coverage is increasing, particularly among blacks and Hispanics. After years with higher uninsurance rates compared to whites, the drop in uninsurance rates in 2013-2014 was 26.4 percent to 15.9 percent for blacks, and 40.3 percent to 33.2 percent for Hispanics. This trend indicates that the Affordable Care Act (ACA) is succeeding in making affordable coverage available for millions of newly-insured Americans so they can access health care when they need it.

In other good news, disparities have been eliminated for some health services, including immunization. Black and white children receive the measles-mumps-rubella vaccine at similar rates, and American Indian children receive hepatitis B vaccines at similar rates as other children. Hispanic and white adults who are obese received nutrition counseling and advice to eat fewer high-fat foods at the same rates--an improvement over 2004 figures showing half of white and 4 out of 10 Hispanics received similar counseling.

Quality of care also improved for most of the priorities in the National Quality Strategy (NQS), but overall quality and racial/ethnic disparities varied widely across the states and showed that some gaps were closing, while others were growing. For example, income-related disparities in two measures related to diabetes and joint symptoms grew larger.

Public reporting is vitally important to monitor progress toward meeting the national goal of eliminating disparities. But reporting at the national level cannot possibly capture the fact that differences in exposure to health risks and access to resources vary depending on where people live. Short distances on maps can translate to large differences in life expectancy.

Racially segregated communities -- where many blacks and Hispanics live -- tend to present greater health risks, partly because of higher poverty rates and also because of the lack of resources needed to live healthy lives (e.g., quality health care, healthy foods, and safe recreation). These communities have suffered for decades as a result of systematic under-investment by both the public and private sectors. Consequently, residents in these communities experience higher rates of mortality and chronic conditions. They have less access to medical care and use fewer health care services. Baltimore is a prime example of these health inequities. For example, out of 100 counties in a recent study, Baltimore ranks in the bottom 10 for income mobility for poor children.

AcademyHealth members are at the forefront of tracking and understanding disparities. They are developing and evaluating models and strategies to reduce and eliminate disparities. Some of this research will be on display at the Annual Research Meeting (ARM) in Minneapolis, MN, June 13-16, 2015. The Disparities Interest Group begins this discussion with a pre-conference meeting that will focus on the role of "place," (both social and environmental) on health and possible solutions to reduce or eliminate health care gaps and health disparities. Presentations will introduce innovative methodological approaches in health equity research on health outcomes, health care delivery, health care quality, and health policy.

The ARM program also features several sessions addressing health care disparities. In particular, there will be a session based on AcademyHealth's Diversity Roundtable recommendation that focuses on the role of place-based policies and diversity in reducing health disparities. We will follow this session with discussions on the 30-year anniversary of the historic "Heckler Report" on minority health and health care disparities. Taken together, these sessions will provide evidence about how much has been accomplished and how much remains to be done.

Darrell J. Gaskin, Ph.D., is Deputy Director, Center for Health Disparities Solutions and Associate Professor, Johns Hopkins University Bloomberg School of Public Health, and Vice Chair of the AcademyHealth Board of Directors.

Thomas A. LaVeist, Ph.D., is Director, Hopkins Center for Health Disparities Solutions and William C. and Nancy F. Richardson Professor in Health Policy, Johns Hopkins University Bloomberg School of Public Health