Assessment of the health of Americans: the average health-related quality of life and its inequality across individuals and groups

BACKGROUND: The assessment of population health has traditionally relied on the population's average health measured by mortality related indicators. Researchers have increasingly recognized the importance of including information on health inequality and health-related quality of life (HRQL) in the assessment of population health. The objective of this study is to assess the health of Americans in the 1990s by describing the average HRQL and its inequality across individuals and groups. METHODS: This study uses the 1990 and 1995 National Health Interview Survey from the United States. The measure of HRQL is the Health and Activity Limitation Index (HALex). The measure of health inequality across individuals is the Gini coefficient. This study provides confidence intervals (CI) for the Gini coefficient by a bootstrap method. To describe health inequality by group, this study decomposes the overall Gini coefficient into the between-group, within-group, and overlap Gini coefficient using race (White, Black, and other) as an example. This study looks at how much contribution the overlap Gini coefficient makes to the overall Gini coefficient, in addition to the absolute mean differences between groups. RESULTS: The average HALex was the same in 1990 (0.87, 95% CI: 0.87, 0.88) and 1995 (0.87, 95% CI: 0.86, 0.87). The Gini coefficient for the HALex distribution across individuals was greater in 1995 (0.097, 95% CI: 0.096, 0.099) than 1990 (0.092, 95% CI: 0.091, 0.094). Differences in the average HALex between all racial groups were the same in 1995 as 1990. The contribution of the overlap to the overall Gini coefficient was greater in 1995 than in 1990 by 2.4%. In both years, inequality between racial groups accounted only for 4–5% of overall inequality. CONCLUSION: The average HRQL of Americans was the same in 1990 and 1995, but inequality in HRQL across individuals was greater in 1995 than 1990. Inequality in HRQL by race was smaller in 1995 than 1990 because race had smaller effect on the way health was distributed in 1995 than 1990. Analysis of the average HRQL and its inequality provides information on the health of a population invisible in the traditional analysis of population health

Awareness in Practice: Tensions in Access to Sensitive Attribute Data for Antidiscrimination

Organizations cannot address demographic disparities that they cannot see. Recent research on machine learning and fairness has emphasized that awareness of sensitive attributes, such as race and sex, is critical to the development of interventions. However, on the ground, the existence of these data cannot be taken for granted. This paper uses the domains of employment, credit, and healthcare in the United States to surface conditions that have shaped the availability of sensitive attribute data. For each domain, we describe how and when private companies collect or infer sensitive attribute data for antidiscrimination purposes. An inconsistent story emerges: Some companies are required by law to collect sensitive attribute data, while others are prohibited from doing so. Still others, in the absence of legal mandates, have determined that collection and imputation of these data are appropriate to address disparities. This story has important implications for fairness research and its future applications. If companies that mediate access to life opportunities are unable or hesitant to collect or infer sensitive attribute data, then proposed techniques to detect and mitigate bias in machine learning models might never be implemented outside the lab. We conclude that today's legal requirements and corporate practices, while highly inconsistent across domains, offer lessons for how to approach the collection and inference of sensitive data in appropriate circumstances. We urge stakeholders, including machine learning practitioners, to actively help chart a path forward that takes both policy goals and technical needs into account

Series 2: Publications : Spectrum (F.H.U.), October, 1993; November, 1996

A newsletter describing gay rights and events, as well as community issues

Folder 24: I & R Ryan White Monthly Report, 1996-12

A breakdown of client demographics from the Foundation for Human Understanding

[Foundation for Human Understanding members list]

List of members of the Foundation for Human Understanding

Folder 16: Brochure of the Women's Health Program of the Nelson-Tebedo Clinic Named for Louise Young and Deb Elder, c. 1995

A brochure for the Young-Elder Women's Health Program, which describes the program, the women involved, and the services the program provides

Series 2: Publications : Spectrum (F.H.U.), October, 1993; November, 1996

A newsletter describing gay rights and events, as well as community issues

Folder 10: LGPC Binder 2, Membership, Bylaws, and Bills, 1996-1998

List of members of the Foundation for Human Understanding

Nelson - Tebedo Community Clinic for AIDS Research, 1989-1990

A funding request from The Foundation for Human Understanding on behalf of the AIDS Resource Center of Dallas, seeking monetary assistance to begin a clinical research facility in Dallas

Folder 16: Brochure of the Women's Health Program of the Nelson-Tebedo Clinic Named for Louise Young and Deb Elder, c. 1995

A brochure for the Young-Elder Women's Health Program, which describes the program, the women involved, and the services the program provides