Racial and Ethnic Disparities in the VA 

Healthcare System 

The Evidence-Based Synthesis Project (ESP) was established to provide timely and accurate syntheses 

of targeted health care topics of particular importance to VA managers and policymakers—and to 

disseminate these reports throughout VA. This ESP reports on racial and ethic disparities within the VA. 

Numerous studies have demonstrated racial and ethnic disparities in U.S. health care. These disparities 

have been demonstrated in the VA healthcare system, where financial barriers to receiving care are 

minimized. The VA is committed to delivering high-quality care in an equitable manner, and, thus to 

eliminating racial and ethnic disparities in health care. To inform this effort, the existing evidence on 

disparities within VA was systematically reviewed to: 

z Determine in which clinical areas racial and ethnic disparities are prevalent, 

z Describe what is known about the sources of those disparities, and 

z Synthesize that knowledge to determine the most promising areas for future research aimed at 

improving quality in VA healthcare. 

The ESP report covers a broad array of areas that include: arthritis and pain management, cancer, 

cardiovascular disease, diabetes, HIV, hepatitis C, mental health, substance use disorders, preventive and 

ambulatory care, rehabilitative and palliative care, as well as other clinical topics. 

Investigators found: 

z No clear indication that disparities are more prevalent in some clinical areas than others; 

z Disparities were more consistently observed for processes that entail more risk or require more 

intensive decision-making, communication, or effort on the part of patients and/or providers (i.e., 

surgery, medication adherence); 

z Studies that examined quality indicators (i.e., blood pressure control, cholesterol) suggest that nonwhite veterans generally fare worse than whites; and 

z In at least one study, differences in the use of cardiovascular procedures reflect overuse among white

rather than underuse among African Americans. 

Investigators caution that some studies in this report did not capture non-VA healthcare use, and thus 

may underestimate or overestimate the degree of disparities. 

For more information about the report's methodology and/or findings, the full report is available at 

http://www.hsrd.research.va.gov/publications/esp/. 

s 

Saha S, Freeman M, Toure J, Tippens K and Weeks C. Racial and ethnic disparities in the VA Healthcare System: A systematic review. June 2007. 

Department of Veterans Affairs, Health Services Research & Development Service, Evidence Synthesis Pilot Program. 

 

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