Racial and Ethnic Disparities in Perceived Barriers to Health Care Among U.S. Adults With Intellectual and Developmental Disabilities

2021 ◽  
Vol 59 (1) ◽  
pp. 84-94
Author(s):  
Henan Li ◽  
Susan L. Parish ◽  
Sandra Magaña ◽  
Miguel A. Morales
Keyword(s):  
Health Care ◽  
Developmental Disabilities ◽  
Medical Care ◽  
Health Care Access ◽  
Perceived Barriers ◽  
Intellectual And Developmental Disabilities ◽  
Usual Source Of Care ◽  
Care Access ◽  
Source Of Care ◽  
Barriers To Health

Abstract Barriers to health care access can greatly affect one's health status. Research shows that U.S. adults with intellectual and developmental disabilities (IDD) have poor health and face barriers such as long waits for appointments. However, whether barriers differ by race and ethnicity has not been examined. We conducted a secondary data analysis using the 2002–2011 Medical Expenditure Panel Survey dataset, and compared perceived barriers of community-living U.S. adults with IDD in three racial and ethnic groups (White, Black, and Latinx). Specifically, we examined the top reasons for not having usual source of care, delaying or foregoing medical care. For Black and Latinx adults with IDD, the most-mentioned reasons for not having usual source of care, delaying or foregoing medical care were “don't like/don't trust doctors,” “don't use doctors,” and “don't know where to get care.” In comparison, the White adults with IDD group's biggest perceived barriers were location and insurance related. All groups cited that being unable to afford care was a top reason for delaying or foregoing care. Policies/interventions to improve health care access in racial/ethnic minorities with IDD must first address the topic of developing trust between patients and the health professions. Insurance and the rising costs of care are also key areas that need attention.

scholarly journals States with fewer criminalizing immigrant policies have smaller health care inequities between citizens and noncitizens

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Maria-Elena De Trinidad Young ◽  
Hiram Beltrán-Sánchez ◽  
Steven P. Wallace
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
State Level ◽  
Comparative Approach ◽  
Usual Source Of Care ◽  
Data Set ◽  
Logistic Regression Models ◽  
Usual Source ◽  
Care Access ◽  
Source Of Care

Abstract Background In the last thirty years, major shifts in immigrant policy at national and state levels has heightened boundaries among citizens, permanent residents, and those with other statuses. While there is mounting evidence that citizenship influences immigrant health care inequities, there has been less focus on how policies that reinforce citizenship stratification may shape the extent of these inequities. We examine the extent to which the relationship between citizenship and health care inequities is moderated by state-level criminalization policies. Methods Taking a comparative approach, we assess how distinct criminalization policy contexts across US states are associated with inequitable access to care by citizenship status. Utilizing a data set with state-level measures of criminalization policy and individual-level measures of having a usual source of care from the National Health Interview Survey, we use mixed-effects logistic regression models to assess the extent to which inequities in health care access between noncitizens and US born citizens vary depending on states’ criminalization policies. Results Each additional criminalization policy was associated with a lower odds that noncitizens in the state had a usual source of care, compared to US born citizens. Conclusion Criminalization policies shape the construction of citizenship stratification across geography, such as exacerbating inequities in health care access by citizenship.

Overcoming the perceived barriers to health care access among single mothers in coastal Kenya

2013 ◽  
Vol 59 (1) ◽  
pp. 189-196 ◽  
Author(s):  
J. J. Cohen ◽  
M. Blevins ◽  
A. Mapenzi ◽  
L. Reppart ◽  
J. Reppart ◽  
...  
Keyword(s):  
Health Care ◽  
Single Mothers ◽  
Health Care Access ◽  
Perceived Barriers ◽  
Barriers To Health Care ◽  
Care Access ◽  
Coastal Kenya ◽  
Barriers To Health

Perceived Barriers to Health Care Access Among Rural Older Adults: A Qualitative Study

2005 ◽  
Vol 21 (3) ◽  
pp. 206-213 ◽  
Author(s):  
R. Turner Goins ◽  
Kimberly A. Williams ◽  
Mary W. Carter ◽  
S. Melinda Spencer ◽  
Tatiana Solovieva
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Qualitative Study ◽  
Health Care Access ◽  
Perceived Barriers ◽  
Barriers To Health Care ◽  
Care Access ◽  
Barriers To Health ◽  
Rural Older Adults

Disparities in Health Status and Health Care Access and Use Among Older American Indians and Alaska Natives and Non-Hispanic Whites in California

2012 ◽  
Vol 24 (5) ◽  
pp. 799-811 ◽  
Author(s):  
Giyeon Kim ◽  
Ami N. Bryant ◽  
R. Turner Goins ◽  
Courtney B. Worley ◽  
David A. Chiriboga
Keyword(s):  
Health Care ◽  
Health Status ◽  
Medical Care ◽  
American Indians ◽  
Health Care Access ◽  
Alaska Natives ◽  
California Health Interview Survey ◽  
Health Care Needs ◽  
Care Needs ◽  
Care Access

Objectives: The present study compared the characteristics of health status and health care access and use among older American Indians and Alaska Natives (AIANs) to those of non-Hispanic Whites (NHWs). Methods: Data were drawn from the 2009 California Health Interview Survey, with a total of 17,156 adults aged 60 and older (198 AIANs and 16,958 NHWs) analyzed. Results: Older AIANs reported poorer physical and mental health than did NHWs. AIANs were less likely than NHWs to see a medical doctor and have a usual source of medical care and were more likely than NHWs to delay getting needed medical care and report difficulty understanding the doctor at their last visit. Discussion: These findings highlight the vulnerability and unmet health care needs of older AIANs. More research on the older AIAN population is clearly needed to document their health care needs in order to better inform efforts to reduce health disparities.

State-Level Sexism and Women’s Health Care Access in the United States: Differences by Race/Ethnicity, 2014–2019

2021 ◽  
pp. e1-e10
Author(s):  
Kristen Schorpp Rapp ◽  
Vanessa V. Volpe ◽  
Hannah Neukrug
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Hispanic Women ◽  
State Level ◽  
The United States ◽  
Barriers To Health Care ◽  
Care Access ◽  
Race Ethnicity ◽  
The Relationship ◽  
Barriers To Health

Objectives. To quantify racial/ethnic differences in the relationship between state-level sexism and barriers to health care access among non-Hispanic White, non-Hispanic Black, and Hispanic women in the United States. Methods. We merged a multidimensional state-level sexism index compiled from administrative data with the national Consumer Survey of Health Care Access (2014–2019; n = 10 898) to test associations between exposure to state-level sexism and barriers to access, availability, and affordability of health care. Results. Greater exposure to state-level sexism was associated with more barriers to health care access among non-Hispanic Black and Hispanic women, but not non-Hispanic White women. Affordability barriers (cost of medical bills, health insurance, prescriptions, and tests) appeared to drive these associations. More frequent need for care exacerbated the relationship between state-level sexism and barriers to care for Hispanic women. Conclusions. The relationship between state-level sexism and women’s barriers to health care access differs by race/ethnicity and frequency of needing care. Public Health Implications. State-level policies may be used strategically to promote health care equity at the intersection of gender and race/ethnicity. (Am J Public Health. Published online ahead of print September 2, 2021: e1–e10. https://doi.org/10.2105/AJPH.2021.306455 )

scholarly journals The shared experiences of insured members and the uninsured in health care access and utilization under Ghana’s national health insurance scheme: Evidence from the Hohoe Municipality

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244155
Author(s):  
Suraiya Umar ◽  
Adam Fusheini ◽  
Martin Amogre Ayanore
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Access ◽  
Health Care Services ◽  
National Health Insurance Scheme ◽  
Insurance Scheme ◽  
Financial Barriers ◽  
Care Access ◽  
Care Services ◽  
Barriers To Health

Background The National Health Insurance Scheme (NHIS) was introduced in Ghana in 2003 to remove financial barriers and to promote equitable access to health care services. Post implementation has been characterized by increases in access and utilization of services among the insured. The uninsured have been less likely to utilize services due to unaffordability of health care costs. In this study, we explored the experiences of the insured members of the NHIS, the uninsured and health professionals in accessing and utilizing health care services under the NHIS in the Hohoe Municipality of Ghana. Methods Qualitative in-depth interviews were held with twenty-five NHIS insured, twenty-five uninsured, and five health care professionals, who were randomly sampled from the Hohoe Municipality to collect data for this study. Data was analyzed using thematic analysis. Results Participants identified both enablers or motivating factors and barriers to health care services of the insured and uninsured. The major factors motivating members to access and use health care services were illness severity and symptom persistence. On the other hand, barriers identified included perceived poor service quality and lack of health insurance among the insured and uninsured respectively. Other barriers participants identified included financial constraints, poor attitudes of service providers, and prolonged waiting time. However, the level of care received were reportedly about the same among the insured and uninsured with access to quality health care much dependent on ability to pay, which favors the rich and thereby creating inequity in accessing the needed quality care services. Conclusion The implication of the financial barriers to health care access identified is that the poor and uninsured still suffer from health care access challenges, which questions the efficiency and core goal of the NHIS in removing financial barrier to health care access. This has the potential of undermining Ghana’s ability to meet the Sustainable Development Goal 3.8 of universal health coverage by the year 2030.

Barriers to health care access and utilization among vietnamese Americans in Southern California

1995 ◽  
Vol 1 (2) ◽  
pp. 91-99 ◽  
Author(s):  
George A. Gellert ◽  
Roberta M. Maxwell ◽  
Kathleen V. Higgins ◽  
Kim Khanh Mai ◽  
Rosann Lowery
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Southern California ◽  
Vietnamese Americans ◽  
Barriers To Health Care ◽  
Care Access ◽  
Barriers To Health
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