The Contribution of Insurance Coverage and Community Resources to Reducing Racial/Ethnic Disparities in Access to Care
June 2003
Health Services Research,
Vol. 38, No. 3 (June 2003)
J. Lee Hargraves, Jack Hadley
More than 6.5 percent of Hispanic and African Americans reported having unmet
medical needs compared to less than 5.6 percent of white Americans. Hispanics
were least likely to see the same doctor at their usual source of care (59 percent),
compared to African Americans (66 percent) and whites (75 percent). Similarly,
Hispanics were less likely than either African Americans or white to have seen
a doctor in the last year (65 percent compared to 76 percent or 79 percent). For
Hispanics, more than 80 percent of the difference from whites was due to differences
in measured characteristics (e.g., insurance coverage, income, and available safety
net services). Differences in measured characteristics between African Americans
and whites explained less than 80 percent of the access disparities.
Lack of health insurance was the single most important factor in white-Hispanic
differences for all three measures and for two of the white-African American
differences. Income differences were the second most important factor, with
one exception. Community characteristics generally were much less important,
with one exception. The positive effects of insurance coverage in reducing disparities
outweigh benefits of increasing physician charity care or access to emergency
rooms.
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