Minority Health and Health Equity Archive

Permanent URI for this collectionhttp://hdl.handle.net/1903/21769

Welcome to the Minority Health and Health Equity Archive (MHHEA), an electronic archive for digital resource materials in the fields of minority health and health disparities research and policy. It is offered as a no-charge resource to the public, academic scholars and health science researchers interested in the elimination of racial and ethnic health disparities.

Browse

Subject: search.filters.subject.access to care

Search Results

Now showing 1 - 7 of 7
  • No Thumbnail Available
    Item
    Disparities in Public Use Data Availability for Race, Ethnic, and Immigrant Groups
    (2010) Johnson, Pamela Jo; Blewett, Lynn A.; Davern, Michael
    Abstract available at publisher's web site.
  • No Thumbnail Available
    Item
    ASCO Examines Impact of Health Care Reform on Cancer Care Disparities; Makes Recommendations for Closing Gaps
    (2011) Newswise, reporter
    To help address serious racial and economic disparities in cancer prevention, diagnosis, and treatment in the United States, the American Society of Clinical Oncology (ASCO) today released a policy statement that outlines specific provisions of 2010 Patient Protection and Affordable Care Act that have the potential to reduce these disparities. ASCO’s statement makes recommendations to ensure that such provisions are carried out effectively, and urges additional steps to address systemic issues including insurance reform, quality of care, prevention, research, and diversity in the health care workforce.
  • No Thumbnail Available
    Item
    American Society of Clinical Oncology Policy Statement: Opportunities in the Patient Protection and Affordable Care Act to Reduce Cancer Care Disparities
    (2011) Moy, B.; Polite, B. N.; Halpern, M. T.; Stranne, S. K.; Winer, E. P.; Wollins, D. S.; Newman, L. A.
    Patients in specific vulnerable population groups suffer disproportionately from cancer. The elimination of cancer disparities is critically important for lessening the burden of cancer. The Patient Protection and Affordable Care Act provides both opportunities and challenges for addressing cancer care disparities and access to care. The American Society of Clinical Oncology (ASCO) advocates for policies that ensure access to cancer care for the underserved. Such policies include insurance reform and the reduction of economic barriers to quality health care. Building on ASCO's prior statement on disparities in cancer care (2009), this article summarizes elements of the health care law that are relevant to cancer disparities and provides recommendations for addressing major provisions in the law. It outlines specific strategies to address insurance reform, access to care, quality of care, prevention and wellness, research on health care disparities, and diversity in the health care workforce. ASCO is committed to leading efforts toward the improvement of cancer care among the most vulnerable patients.
  • No Thumbnail Available
    Item
    Racial and Ethnic Disparities in Access to Care for Children With Special Health Care Needs
    (2002) NEWACHECK, P; HUNG, Y; WRIGHT, K
    OBJECTIVE: Numerous studies have examined racial and ethnic differences in access to and utilization of health services. However, few studies have addressed these issues with respect to children with special health care needs. This study examines whether disparities in access and utilization are present among black, white, and Hispanic children identified as having special health care needs. METHODS: We analyzed data on 57 553 children younger than 18 years old included in the 1994-95 National Health Interview Survey on Disability. Of these, 10 169, or 17.7% of the sample, were identified as having an existing special health care need. Bivariate and multivariate analyses were used to assess how race and ethnicity are related to measures of access and utilization, such as usual source of care, missed care, and use of physician and hospital services. RESULTS: Our analyses show that among children with special health care needs, minorities were more likely than white children to be without health insurance coverage (13.2% vs 10.3%; P <.01), to be without usual source of care (6.7% vs 4.3%; P <.01), and to report inability to get needed medical care (3.9% vs 2.8%; P <.05). Also, white children with special health care needs were more likely than their minority counterparts to have used physician services (88.6 vs 85.0; P <.01); however, minority children with special health care needs were more likely to have been hospitalized during the past year (7.6% vs 6.3%; P < 0.5). After adjustments for confounding variables (income, insurance coverage, health status, and other variables), racial and ethnic differences in access and utilization were attenuated but remained significant for several measures (without a usual source of care, receipt of care outside of a doctor's office or HMO, no regular clinician, no doctor contacts in past year, and volume of doctor contacts). Gaps in access were more frequent and generally larger for Hispanic children with special health care needs. CONCLUSIONS: Our analysis indicates that access and utilization disparities remain between white and minority children with special health care needs, with Hispanic children experiencing especially disparate care.
  • No Thumbnail Available
    Item
    Racial Disparities in Medicaid Enrollment and Prenatal Care Initiation Among Pregnant Teens in Florida
    (2008) Kuo, Tzy-Mey; Gavin, Norma I.; Adams, E Kathleen; Ayadi, M Femi
    BACKGROUND: Teens and racial and ethnic minority women are less likely to initiate prenatal care (PNC) in the first trimester of pregnancy than their counterparts. OBJECTIVE: This study examines the impact of Medicaid program changes in the late 1990s on the timing of Medicaid enrollment and PNC initiation among pregnant teens by race and ethnicity. RESEARCH DESIGN: Using Medicaid enrollment and claims data and a difference-in-differences method, we examine how the patterns of prepregnancy Medicaid enrollment, PNC initiation, and racial and ethnic disparities in PNC changed over time after controlling for person- and county-level characteristics. SUBJECTS: We included 14,089 teens in Florida with a Medicaid-covered delivery in fiscal years 1995 and 2001. MEASURES: Prepregnancy enrollment was defined as enrollment 9 or more months before delivery; late or no PNC was defined as initiation of PNC within 3 months of delivery or not at all. RESULTS: For teens enrolled in traditional welfare-related categories, the proportion with prepregnancy Medicaid enrollment increased and the proportion with late or no PNC declined from 1995 to 2001. Teens enrolled under the Omnibus Budget Reconciliation Act (OBRA) expansion category in 2001 were less likely than welfare-related teen enrollees to have prepregnancy coverage but were more likely to initiate PNC early. Racial disparities were found in PNC initiation among the 1995 welfare-related group and the 2001 expansion group but were eliminated or greatly reduced among the 2001 welfare-related group. CONCLUSIONS: Providing public insurance coverage improves access to care but is not sufficient to meet Healthy People 2010 goals or eliminate racial and ethnic disparities in PNC initiation.
  • No Thumbnail Available
    Item
    A National Study of Chronic Disease Prevalence and Access to Care in Uninsured U.S. Adults
    (2008) Wilper, Andrew P.; Woolhandler, Steffie; Lasser, Karen E.; McCormick, Danny; Bor, David H.; Himmelstein, David U.
    Background: No recent national studies have assessed chronic illness prevalence or access to care among persons without insurance in the United States. Objective: To compare reports of chronic conditions and access to care among U.S. adults, by self-reported insurance status. Design: Population-based survey. Setting: National Health and Nutritional Examination Survey (1999–2004). Participants: 12 486 patients age 18 to 64 years. Measurements: Estimates of national rates of cardiovascular disease, hypertension, diabetes, hypercholesterolemia, active asthma or chronic obstructive pulmonary disease, previous cancer, and measures of access to care. Results: On the basis of National Health and Nutrition Examination Survey (1999–2004) responses, an estimated 11.4 million (95% CI, 9.8 million to 13.0 million) working-age Americans with chronic conditions were uninsured, including 16.1% (CI, 12.6% to 19.6%) of the 7.8 million with cardiovascular disease, 15.5% (CI, 13.4% to 17.6%) of the 38.2 million with hypertension, and 16.6% (CI, 13.2% to 20.0%) of the 8.5 million with diabetes. After the authors controlled for age, sex, and race or ethnicity, chronically ill patients without insurance were less likely than those with coverage to visit a health professional (6.2% vs. 22.6%) and have a standard site for care (6.2% vs. 26.1%) and more likely to identify an emergency department as their standard site for care (7.1% vs. 1.1%) (P 0.001 for all comparisons). Limitation: The study was cross-sectional and used self-reported insurance and disease status. Conclusion: Millions of U.S. working-age adults with chronic conditions do not have insurance and have poorer access to medical care than their insured counterparts.
  • No Thumbnail Available
    Item
    Disparities in Health Care — From Politics to Policy
    (2004) Steinbrook, Robert
    On December 22, 2003, as many Americans began their Christmas holidays, the DHHS released two comprehensive reports about health care, the National Healthcare Quality Report and the National Healthcare Disparities Report.Four years earlier, Congress had passed a law requiring the AHRQ, which is part of the DHHS, to report annually on both the overall quality of health care and disparities in health care among racial and other groups. It is standard procedure for government reports to go through a clearance process before their public release. The review may involve substantial back and forth among many officials, and it usually escapes public scrutiny. Moreover, federal reports, particularly those that are released during holiday periods, often attract little attention. Within weeks, however, it became widely known that although the December report on disparities in health care contained essentially the same tables of data as the report that AHRQ officials had submitted for approval six months earlier, it otherwise differed markedly from the July version. Democratic staff members in the House of Representatives who work for Representative Henry A. Waxman (D-Calif.), the ranking minority member of the House Committee on Government Reform, called attention to these differences by making public an internal AHRQ draft of the executive summary from June 2003. They issued a report on the changes as “a case study in politics and science.”