Health Disparity Measures in HD*Calc

The Health Disparities Calculator (HD*Calc) uses SEER Data or other population based health data (e.g., National Health Interview SurveyExternal Web Site Policy, California Health Interview SurveyExternal Web Site Policy, Tobacco Use Supplement to the Current Population SurveyExternal Web Site Policy, and National Health and Nutrition Examination SurveyExternal Web Site Policy) to calculate two types of disparity measures:

  1. Absolute Disparity, which includes Range Difference (RD), Between Group Variance (BGV), Absolute Concentration Index (ACI), and Slope Index of Inequality (SII)
  2. Relative Disparity, which includes Range Ratio (RR), Index of Disparity (IDisp), Mean Log Deviation (MLD), Relative Concentration Index (RCI), Theil Index (T), Kunst Mackenbach Relative Index (KMI), Relative Index of Inequality (RII).

Associated statistics include: standard errors, confidence intervals, and relative change over time for trends. The output is presented in both tabular and graphic formats; this allows users to specify various conditions and formats. Resulting disparity tables and graphs can be exported from the program. In addition to summary measures, HD*Calc also provides pair wise comparisons that allow the user to explore underlying trends in the data.

This application extends the work published in the National Cancer Institute Surveillance Monograph Series entitled Methods for Measuring Cancer Disparities, which evaluates measures of health disparities included in HD*Calc. The monograph discusses major issues that may affect the choice of summary measures of disparity and systematically reviews methods used in health disparities research. Methods for Measuring Cancer Disparities is recommended for those unfamiliar with the measures available in HD*Calc or interested in a comparative summary of available measures of health disparities (PDF).

A second monograph, Selected Comparisons of Measures of Health Disparities: A Review Using Databases Relevant to Healthy People 2010 Cancer-Related Objectives, uses case studies to analyze the performance and appropriateness of various measures of health disparities.

Several articles have been published on assessing health disparities measures. You may be interested in the peer-reviewed articles below, which discuss assessment of health disparities measures relevant to HD*Calc.

Harper S, King NB, Meersman SC, Reichman ME, Breen N, Lynch J. Implicit value judgments in the measurement of health inequalities. Milbank Q. 2010 Mar;88(1):4-29. [AbstractExternal Web Site Policy]
Harper S, Lynch J, Meersman SC, Breen N, Davis WW, Reichman MC. Trends in area-socioeconomic and race-ethnic disparities in breast cancer incidence, stage at diagnosis, screening, mortality, and survival among women ages 50 years and over (1987-2005). Cancer Epidemiol Biomarkers Prev. 2009 Jan;18(1):121-31. [AbstractExternal Web Site Policy]
Harper S, Lynch J, Meersman SC, Breen N, Davis WW, Reichman ME. An overview of methods for monitoring social disparities in cancer with an example using trends in lung cancer incidence by area-socioeconomic position and race-ethnicity, 1992-2004. Am J Epidemiol 2008 Apr 15;167(8):889-99. [AbstractExternal Web Site Policy]