Racial/Ethnic and Gender Disparities in Health Care Use and Access
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Objective: To document racial/ethnic and gender differences in health service use and access after the Affordable Care Act went into effect. Data Source: Secondary data from the 2006–2014 National Health Interview Survey. Study Design: Linear probability models were used to estimate changes in health service use and access (i.e., unmet medical need) in two separate analyses using data from 2006 to 2014 and 2012 to 2014. Data Extraction: Adult respondents aged 18 years and older ( N = 257,560). Principal Findings: Results from the 2006–2014 and 2012–2014 analyses show differential patterns in health service use and access by race/ethnicity and gender. Non‐Hispanic whites had the greatest gains in health service use and access across both analyses. While there was significant progress among Hispanic respondents from 2012 to 2014, no significant changes were found pre–post‐health care reform, suggesting access may have worsened before improving for this group. Asian men had the largest increase in office visits between 2006 and 2014, and although not statistically significant, the increase continued 2012–2014. Black women and men fared the worst with respect to changes in health care access. Conclusions: Ongoing research is needed to track patterns of health service use and access, especially among vulnerable racial/ethnic and gender groups, to determine whether existing efforts under health care reform reduce long‐standing disparities.
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The higher proportion of White and female individuals reflects the tendency for White females to attend mental health services more often and their greater likelihood of participating in research studies.
“reflecting the tendency for White females to attend mental health services more often than their male/non-White counterparts, and their greater likelihood of participating in research studies [46, 47].”
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“Sociodemographic characteristics The RADAR-MDD cohort has a higher proportion of White and female individuals than would typically be seen in the general population or depressed population [45] reflecting the tendency for White females to attend mental health services more often than their male/non-White counterparts,…”
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- Authors
- Manuel, J. I.
- Affiliations
- New York University (US)
- Corresponding author
- Manuel, Jennifer I.
- ORCID
- Manuel, Jennifer I.
- Venue
- Health Services Research
- Publisher
- Wiley
- Published
- 2017-05-08
- Volume
- 53
- Issue
- 3
- Pages
- 1407-1429
- ISSN
- 0017-9124 (ISSN-L)
- 1475-6773
- PMC
- PMC5980371
- OpenAlex
- W2614015444
- Cited by
- 378
- References
- 54
- Citations by year
- 2026: 17 · 2025: 45 · 2024: 55 · 2023: 70 · 2022: 83 · 2021: 53 · 2020: 35 · 2019: 14 · 2018: 6
- FWCI
- 27.02
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Health Services Research (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Drug Abuse (K01DA035330)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Health › Public Health and Social Inequalities
- Keywords
- racial and ethnic disparities, gender disparities, health care access, health care utilization, unmet medical needs, Affordable Care Act, health care reform, Hispanic Americans, African Americans, Asian Americans, office visits, vulnerable populations
- MeSH terms
- Adult, Black or African American, Ethnicity, Female, Health Services Accessibility, Health Services Research, Health Status, Hispanic or Latino, Humans, Male, Mental Health, Middle Aged, Patient Acceptance of Health Care, Sex Factors, Socioeconomic Factors, United States, Patient-Centered Care, White People, Racial Groups, Patient Protection and Affordable Care Act
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