Awareness of racial and socioeconomic health disparities in the United States: the national opinion survey on health and health disparities, 2008-2009.

INTRODUCTION: Recent initiatives aim to improve public awareness of health disparities. However, little research has actually documented the US public's awareness of racial/ethnic and socioeconomic health disparities. We sought to determine 1) whether the US public is aware of racial, educational, and income disparities in health, 2) whether awareness differs across these disparity domains, and 3) what respondent characteristics are associated with awareness of racial, educational, and income disparities in health. METHODS: We conducted the National Opinion Survey on Health and Health Disparities with 2,791 US adults. We asked respondents to answer questions about disparities in health between 1 of several pairs of population subgroups: African Americans versus whites, non-high school graduates versus high school graduates, high school graduates versus college graduates, the poor versus the middle class, or the middle class versus the rich. We used χ(2) tests and logistic regression to compare correlates of respondents' awareness of disparities across the different pairs of population subgroups. RESULTS: Most respondents were aware of health disparities between the poor and middle class (73%); fewer were aware of health disparities between African Americans and whites (46%). Although respondents recognized that education is associated with many positive life outcomes, they were less aware of the link between education and health. Respondents who were younger, less educated, lower-income, healthier, or politically conservative were less likely to be aware of health disparities. CONCLUSION: Public awareness of disparities in health differs depending on both the type of disparity and the characteristics of the individual respondent.

Grading and reporting health and health disparities.

Report cards are widely used in health for drawing attention to performance indicators. We developed a state health report card with separate grades for health and health disparities to generate interest in and awareness of differences in health across different population subgroups and to identify opportunities to improve health. We established grading curves from data for all 50 states for 2 outcomes (mortality and unhealthy days) and 4 life stages (infants, children and young adults, working-age adults, and older adults). We assigned grades for health within each life stage by sex, race/ethnicity, socioeconomics, and geography. We also assigned a health disparity grade to each life stage. Report cards can simplify complex information for lay audiences and garner media and policy maker attention. However, their development requires methodologic and value choices that may limit their interpretation.

Using the Wisconsin County Health Rankings to catalyze community health improvement.

BACKGROUND: Assessment is a core function of public health; however, standard community health assessments often remain within the boundaries of the traditional public health system and rarely elicit public discussion and community-wide action. The University of Wisconsin Population Health Institute developed the annual Wisconsin County Health Rankings (Rankings) report in 2003 with three primary goals: (1) to increase media attention to local health outcomes and determinants; (2) to highlight the broad range of factors that influence health; and (3) to catalyze community health improvement efforts. METHODS: We assessed how well the Rankings met these goals through an examination of media coverage and a survey of the local public health community following the 2006 report. FINDINGS: Newspaper, television, and radio media across the state covered the Rankings, highlighting local results for outcomes and a broad range of determinants. Local public health officials used the Rankings for educating policy makers and community partners, performing needs assessments, and identifying program targets. CONCLUSIONS: The Rankings report is an approach to community health assessment that has received media attention and been found to be useful by local public health officials in their community health improvement efforts.