Racial/Ethnic and Gender Disparities in Health Care Use and Access

Abstract

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.

Racial/Ethnic Differential Effects of Medicaid Expansion on Health Care Access

“…Similar to previous studies about racial/ethnic disparities in having personal physicians and doctor visits after the ACA (Sommers et al. ; Manuel ), we found statistically significant increase in the probability of having personal doctors across all racial/ethnic groups except for Hispanics. Although Hispanic populations in expansion states had 4.93 higher probability of having personal doctors associated with Medicaid expansion, it was not statistically significant.…”

Facilitators and Barriers to Pre-Exposure Prophylaxis (PrEP) Use Among Black Individuals in the United States: Results from the National Survey on HIV in the Black Community (NSHBC)

“…Trust in health care provider and health care quality were assessed by asking “how much do you trust your doctor or clinic to offer you high quality medical care?” and “how would you rate the quality of medical care that you have received from your regular doctor or healthcare provider in the past 12 months?” 36 Based on a scale that has been utilized previously 18,19,37 , we selected 4 items that explore HIV conspiracy beliefs and mistrust in the US government around HIV-related issues: (1) “There is a cure for HIV but the government is withholding it from the poor.” (2) “The medicine that doctors prescribe to treat HIV is poison.” (3) The government usually tells the truth about major health issues, like HIV/AIDS“; and (4) “HIV is a man-made virus.” Responses were re-coded so that a higher score (1 to 5) indicated a higher level of mistrust (Cronbach alpha 0.79).…”

“…15–17 Knowledge of and access to PrEP may differ by gender because Black women report more frequent visits with health care providers than Black men. 18 In addition, historical and ongoing oppression and racism have led to mistrust of the US government, the health care system, health care providers, and HIV conspiracy beliefs within the Black community. These factors have been identified as barriers to HIV prevention and treatment.…”

National Estimates of Emergency Department Visits for Antibiotic Adverse Events Among Adults—United States, 2011–2015

“…ED visits for antibiotic AEs were disproportionately made by women (71.8%); however, this finding is consistent with higher ED utilization in general by women 33 and higher ED utilization by women for other types of adverse drug events, 22 so it is uncertain if targeting antibiotic safety messages to women would be an effective approach to reducing antibiotic AEs. [34][35][36][37] Estimates of the number needed to harm (NNH) for individual antibiotics by patient age can also inform clinician decisionmaking when selecting among agents with similar activity.…”