Health disparities among racial and ethnic groups have a long history and continue to exist in the United States. The U.S. government has established as a goal for the year 2010 the elimination of racial/ethnic health differences in six areas. This article examines disparities in one of those areas: access to high-quality health care. Several measures of access to and use of health care services are studied both nationally and in 13 diverse states. The authors find that both the magnitude of racial and ethnic disparity and the reasons behind it depend significantly on the state, the ethnic group, and the type of outcome measure being studied. Such information can be valuable for state and national policy makers in targeting resources and in designing effective strategies for the elimination of racial and ethnic disparities.
Get full access to this article
View all access options for this article.
References
1.
Ammons L.1997. Demographic Profile of Health-Care Coverage in America in 1993. Journal of the National Medical Association89 (11): 737-744.
2.
Andersen, R. M., A. Giachello, and L. Aday. 1986. Access of Hispanics to Health Care and Cuts in Services: A State of the Art Overview. Public Health Reports18:49-74.
3.
Brick, P. D., G. Kenney, R. McCullough-Harlin, S. Rajan, F. Scheuren, K. Wang, J. M. Brick, and P. Cunningham. 1999. 1997 National Survey of America’s Families: Survey Methods and Data Reliability. NSAF Methodology Report No. 1. Washington, DC: Urban Institute. Available at http://newfederalism.urban.org/nsaf/design.html
4.
Brown, E. R., V. D. Ojeda, R. Wyn, and R. Levan. 1999. Racial and Ethnic Disparities in Access to Health Insurance and Health Care. Unpublished Manuscript, University of California, Los Angeles.
5.
Cornelius, L. J.1991. Access to Medical Care for Black Americans with an Episode of Illness. Journal of the National Medical Association83 (7): 617-626.
6.
Cornelius, L. J.. 1993. Ethnic Minorities and Access to Medical Care: Where Do They Stand?Journal of the Association for Academic Minority Physicians4 (1): 16-24.
7.
Council of Economic Advisers. 1998. Changing America: Indicators of Social and Economic Well-Being by Race and Hispanic Origin. Washington, DC: Government Printing Office.
8.
Davidson, R., and J. MacKinnon. 1993. Estimation and Inference in Econometrics. New York: Oxford University Press.
9.
Federal Interagency Forum on Child and Family Statistics. 1999. America’s Children: Key National Indicators of Well-Being, 1999. Washington, DC: Government Printing Office.
10.
Geronimus, A. T., J. Bound, T. A. Waidmann, M. M. Hillemeier, and P. B. Burns. 1996. Excess Mortality Among Blacks and Whites in the United States. New England Journal of Medicine335 (21): 1552-1558.
11.
Guyer, B., D. L. Hoyert, J. A. Martin, S. J. Ventura, M. F. MacDorman, and D. M. Strobino. 1999. Annual Summary of Vital Statistics—1998. Pediatrics104 (6): 1229-1246.
12.
James, S. A.1993. Racial and Ethnic Differences in Infant Mortality and Low Birth Weight: A Psychosocial Critique. Annals of Epidemiology3:130-136.
13.
Krebs-Carter, M., and J. Holahan. 2000. State Strategies for Covering Uninsured Adults. Assessing the New Federalism Discussion Paper No. 00-02.
14.
Long, E.1993. Breast Cancer in African-American Women: Review of the Literature. Cancer Nursing16:1-24.
15.
Long, S. H.1987. Public versus Employment-related Health Insurance: Experience and Implications for Black and Nonblack Americans. Milbank Quarterly65 (Suppl. 1): 200-212.
16.
Martin, L. M., E. E. Calle, P. A. Wingo, and C.W.J. Heath. 1996. Comparison of Mammography and Pap Test Use from the 1987 and 1992 National Health Interview Surveys: Are We Closing the Gaps?American Journal of Preventive Medicine12:82-90.
17.
National Center for Health Statistics. 1999. Health, United States, 1999, Health and Aging Chartbook. Hyattsville, MD: Government Printing Office.
18.
Newachek, P. W., D. C. Hughes, and J. J. Stoddard. 1996. Children’s Access to Primary Care: Differences by Race, Income, and Insurance Status. Pediatrics97 (1): 26-32.
19.
Pearlman, D. N., W. Rakowski, B. Ehrich, and M. A. Clark. 1996. Breast Cancer Screening Practices Among Black, Hispanic, and White Women: Reassessing Differences. American Journal of Preventive Medicine12:327-337.
20.
Rajan, S., S. Zuckerman, and N. Brennan. 1999. Verifying Insurance Coverage: Impact on Measuring the Uninsured within the National Survey of America’s Families. Urban Institute Working Paper.
21.
Ren, X. S., and B. C. Amick. 1996. Racial and Ethnic Disparities in Self-Assessed Health Status: Evidence from the National Survey of Families and Households. Ethnic Health1 (3): 293-303.
22.
Wells, K. B., J. M. Golding, R. L. Hough, M. A. Burnam, and M. Karno. 1989. Acculturation and the Probability of Use of Health Services by Mexican Americans. Health Services Research24 (2): 237-257.
23.
Zuvekas, S. H., and R.M. Weinick. 1999. Changes in Access to Care, 1977-1996: The Role of Health Insurance. Health Services Research34:270-279.
