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Let's Discuss! Health Disparities and the HD*Calc

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July's cyber-seminar took a look at measuring health disparities and highlighted a tool, HD*Calc, a freely available statistical software designed to generate multiple summary measures to evaluate and monitor health disparities so to researchers and practitioners can inform their programs and improve the community's health.  We were delighted to have an overview of the tool from Dr. Nancy Breen (NCI) and then to have Dr. Eva Wong (Seattle-King County Health Department) share an example of how their county has already been applying HD*Calc in their work and the impact.

Now it is your turn to share your experience and knowledge...ask a question of the speakers or your fellow R2R members, share your stories of health disparities and measurement.  What lessons have you learned or additional tools have you used that others might benefit from?

Join us in the discussion!

If you would like to request a PDF copy of the slides from the seminar, please use the contact us tab or email

If you missed the live seminar, the archive will be available approximately one week following the live session.  Watch and then come share your thoughts.


I am an evaluator for a

I am an evaluator for a Community Transformation Grant program. I am wondering about the appropriteness of HD Calc for measuring trends in diparities using county- level BRFFS and YBRFS data. Would those data be appropriate for HD Calc as they are all that is available and is it likely that any changes might be recognized over the 4-year intervention period? Thank you

Thanks for the great

Thanks for the great question, William!  I know that HD*Calc is designed to work with SEER Stat and other population-based health data sets so I would think that BRFSS and YRBSS data would be appropriate, but I have shared your post with the speakers and they will be able to provide the definitive and more technical response which will hopefully help you decide if this tool will aid you in your work. In the meantime, you can learn a little more about the measures and datasets for HD*Calc at:

I also wanted to share a question that came in late after the seminar last week as I thought the answer might be of use to others.  JMartin in VA asked, "Please indicate if HD*Calc is a supplement to or replacement for analyses of covariance? Is the key a multi-way rather than two-way comparison? (Trying to decide where the method fits with what I know about.)"

We look forward to hearing more from Drs. Breen and Wong or anyone else who might have a thought or comment.

To William:  HD*Calc is a

To William:  HD*Calc is a tool to help calculate each of 11 disparity measures.  We have used it for county-level BRFSS data (our county does not participate in YRBS).  HD*Calc does not conduct analyses of trend, however, you can export HD*Calc results quickly and easily and use it in another free NCI software, JoinPoint.  JoinPoint statistical software analyses trends and considers the stability of the estimates.  You can read more about JoinPoint at the  NCI website above.

To JMartin: The measures in HD*Calc calculate disparity—they’re like an automatic calculator, and are not statistical tests of difference.  There will be no p-values in your HD*Calc output.  Many of these measures come from the fields of economics.  One advantage of these measures is the ability to summarize multiple groups simultaneously in one number/result, rather than multiple two-way comparison like you would have if you calculated risk ratios or risk differences.

I work with Dr. Nancy Breen

I work with Dr. Nancy Breen at NCI on the HD*Calc program team and wanted to add to Dr. Wong's responses...

To William:  HD*Calc allows for the import of population-based health data therefore, BRFSS and YBRSS data are ok to import.  Bear in mind that imported statistics are not calculated by HD*Calc but by the initial software the user chooses to use.  HD*Calc generates multiple measures of disparity after importing data into the calculator software.

To JMartin: Keep in mind that HD*Calc is not intended to replace other analyses.  It offers a suite of summary measures so that users can compare the results of various approaches to measuring disparities.  HD*Calc can also be used for pairwise comparison.