This 2007 report is the fifth National Healthcare Disparities Report (NHDR). It is produced by the Agency for Healthcare Research and Quality (AHRQ) on behalf of the U.S. Department of Health and Human Services (HHS) and in collaboration with an HHS-wide Interagency Work Group. The NHDR provides a comprehensive national overview of disparities in health care among racial, ethnic, and socioeconomic groups in the general U.S. population and within specific priority populations, and it tracks the progress of activities to reduce disparities. The NHDR tracks disparities related to the quality of and access to health care. This fifth report attempts to answer the following question: Are we getting better at addressing disparities in the quality of and access to health care for priority populations in America? To do this, the report examines a set of 42 measures of quality and 8 measures of access. For each measure, the 2007 NHDR attempts to present a snapshot of the gaps between each racial, ethnic, and socioeconomic priority group and a comparison group. More importantly, where gaps exist, this report attempts to systematically discuss whether these gaps are getting bigger or smaller. Measures of health care quality address the extent to which providers and hospitals deliver evidence- based care for specific services, as well as the outcomes of the care provided. They are organized around four dimensions of quality-effectiveness, patient safety, timeliness, and patient centeredness-and cover four stages of care-staying healthy, getting better, living with illness or disability, and coping with the end of life. Measures of health care access include assessments of how easily patients are able to get needed health care and their actual use of services. They are organized around two dimensions of access-facilitators and barriers to care and health care utilization. The NHDR is complemented by its companion report, the National Healthcare Quality Report (NHQR), which uses the same quality measures as the NHDR to provide a comprehensive overview of the quality of health care in America. Both reports measure health care quality and track changes over time, but with different orientations. The NHQR addresses the current state of health care quality and the opportunities for improvement for all Americans as a whole. In the 2007 NHDR, three key themes emerge: Overall, disparities in health care quality and access are not getting smaller; Progress is being made, but many of the biggest gaps in quality and access have not been reduced; The problem of persistent uninsurance is a major barrier to reducing disparities.