A Summary Measure of Health Disparity SYNOPSISObjectives. Eliminating health disparities is a goal of Healthy People 2010. In order to track progress toward this goal, we need improved methods for measuring disparity. The authors present the Index of Disparity (ID) as a summary measure of disparity.Methods. The ID, a modified coefficient of variation, was used to measure disparity across populations defined on the basis of race/ethnicity, income, education, and gender. Disparity was also assessed for a diverse range of health indicators and over time to monitor trends.

Background-Healthy People 2010 (HP2010) objectives are based on two overarching goals: 1) to increase years and quality of healthy life, and 2) to eliminate disparities among subgroups of the population. Four hundred and sixty-seven specific objectives consistent with these goals were outlined, baseline data were identified when available, and specific targets were set for the year 2010. This report discusses the tech niques that are being used to measure progress toward these two goals. Process-In order to promote consistency in monitoring across different objectives, a minimum template of subgroups was adopted for the population-based objectives in HP2010. A workgroup of individuals representing the U.S. Department of Health and Human Services agencies involved in HP2010 was convened to consider the issues related to monitoring progress toward the two goals of HP2010. The workgroup concurred with the recommendations in this report. Recommendations-Progress toward target attainment can be monitored for all objectives with at least one data point beyond the baseline. For those objectives that are based on data for a population, progress toward target attainment can also be measured for subgroups of the population. Progress toward the elimination of disparity for individual population subgroups can be measured in terms of the percent difference between each subgroup rate and the most favorable or ''best'' subgroup rate in each domain. For purposes of measuring disparity relative to the ''best'' subgroup rate, all measures are expressed in terms of adverse events.

To eliminate disparities, we need a means to assess disparities across many types of health indicators. Furthermore, for a given health indicator, disparities may differ for populations defined on the basis of race/ethnicity, education, income, and so on. The ID is a simple method for summarizing disparities across groups within a population that can be applied across health indicators regardless of magnitude, over time to monitor trends, and across different populations.

In the late 1950's and early 1960's, a series of studies was installed in the central hardwood forest to determine if size of clearcut opening affects the growth rate and species composition of new stands. In 1991, about 30 years after cutting, stand data were collected in 89 openings ranging in size from 0.04 to 1.61 acres. Species composition varied from locations in West Virginia to those in Illinois and from Ohio to Kentucky. For example, there were more maple and birch in West Virginia than in Illinois, regardless of opening size. Some of the difference in species composition and growth rate is related to site quality but there also are differences due to size of opening. Most of the oak and hickory were on the poorer sites while yellow-poplar was more abundant on the better sites. The number of stems per acre increased with opening size; however, the number of stems of shade-tolerant species constituted a greater proportion of the stand in small openings (< 0.5 acre), while the proportion of intolerant species increased in larger openings. Basal area and volume of the current stands seem to increase markedly with opening size for openings up to at least an acre. The greatest reduction in growth is nearest the border of the opening, though some effect on growth extends at least 100 feet into the opening. There also is a strong interaction between border effect and opening size. Productivity is greater at a given distance from the border for larger openings. Opening size has a major influence on stand characteristics after about 30 years.

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