Assessing Health Disparities in the Air Force


Name: J. J. Hatzfield

Rank: Capt., USAF

Organization: John Hopkins University

Performance Site: Johns Hopkins University, Baltimore, MD

Year Published: 2008

Abstract Status: Final


Civilian healthcare research has typically shown that healthcare indicators can vary widely, and often depend on an individual's race, socio-economic status, and in some cases, gender. Within the military healthcare system, however, access to healthcare is provided equally'regardless of race, socio-economic status, or gender. Furthermore, discrimination based on these and other factors is prohibited within the organization as a whole. Even still, health disparity research within the military healthcare system suggests that in some cases, health status may differ by race, gender, and rank. These studies, which have mainly focused on clinical outcomes, do not conclusively identify disparities in quality of care, but do suggest that there are health differences that could be associated with differing levels of quality of care.

At this time there is little research to show if the disparity in quality of care, which has been identified within civilian healthcare systems, is mirrored in the military healthcare system, particularly in the preventive care provided in the primary care setting. Screening and management of chronic diseases, including diabetes and asthma, as well as hypertension and dyslipidemia (two major risk factors for heart disease), account for a significant portion of the primary care resources, and also threaten the readiness of the active duty members with the Air Force.

This descriptive, correlational study aims to assess for disparities in quality of care measures for screening and management of chronic diseases by race/ethnicity, rank, and gender through the use of existing clinical and administrative data. Capitalizing on the use of this large dataset, this study will also test if rank or gender moderate the relationship between race/ethnicity and quality of care measures. Identifying moderation effects of rank and gender is essential to fully understand potential disparities and to determine meaningful interventions.

If there is no health disparity identified in the primary care setting within the military healthcare system, then perhaps there are lessons that can be translated to civilian healthcare systems. On the other hand, if a disparity in quality of health care does exist, then appropriate measures must be explored to improve quality of care and maintain a fit, healthy, and deployable active duty force.


Final Report is available online: