Barriers to Health Care Among Adults With Minoritized Identities in the United States, 2013–2017

2020 ◽  
Vol 110 (6) ◽  
pp. 857-862
Author(s):  
Stephanie M. Hernandez ◽  
P. Johnelle Sparks

Objectives. To examine the relationship between minoritized identity and barriers to health care in the United States. Methods. Nationally representative data collected from the 2013 to 2017 waves of the National Health Interview Survey were used to conduct descriptive and logistic regression analyses. Men and women were placed in 1 of 4 categories: no minoritized identities, minoritized identities of race/ethnicity (MIoRE), minoritized identities of sexuality (MIoS), or minoritized identities of both race/ethnicity and sexuality (MIoRES). Five barriers to health care were considered. Results. Relative to heterosexual White adults and after controlling for socioeconomic status, adults with MIoRE were less likely to report barriers, adults with MIoS were more likely to report barriers, and adults with MIoRES were more likely to report barriers across 2 of the study measures. Conclusions. Barriers to care varied according to gender, minoritized identity, and the measure of access to health care itself. Public Health Implications. Approaching health disparities research using an intersectional lens moves the discussion from examining individual differences to examining the role of social structures such as the health care system in maintaining and reproducing inequality.

2016 ◽  
Vol 106 (8) ◽  
pp. 1463-1469 ◽  
Author(s):  
Julia T. Caldwell ◽  
Chandra L. Ford ◽  
Steven P. Wallace ◽  
May C. Wang ◽  
Lois M. Takahashi

2021 ◽  
pp. e1-e10
Author(s):  
Kristen Schorpp Rapp ◽  
Vanessa V. Volpe ◽  
Hannah Neukrug

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 )


2008 ◽  
Vol 19 (3) ◽  
pp. 731-742 ◽  
Author(s):  
Jeanette Kane Ziegenfuss ◽  
Micahel Davern ◽  
Lynn A. Blewett

2020 ◽  
Vol 110 (6) ◽  
pp. 815-822 ◽  
Author(s):  
Mary K. Wolfe ◽  
Noreen C. McDonald ◽  
G. Mark Holmes

Objectives. To quantify the number of people in the US who delay medical care annually because of lack of available transportation and to examine the differential prevalence of this barrier for adults across sociodemographic characteristics and patient populations. Methods. We used data from the National Health Interview Survey (1997–2017) to examine this barrier over time and across groups. We used joinpoint regression analysis to identify significant changes in trends and multivariate analysis to examine correlates of this barrier for the year 2017. Results. In 2017, 5.8 million persons in the United States (1.8%) delayed medical care because they did not have transportation. The proportion reporting transportation barriers increased between 2003 and 2009 with no significant trends before or after this window within our study period. We found that Hispanic people, those living below the poverty threshold, Medicaid recipients, and people with a functional limitation had greater odds of reporting a transportation barrier after we controlled for other sociodemographic and health characteristics. Conclusions. Transportation barriers to health care have a disproportionate impact on individuals who are poor and who have chronic conditions. Our study documents a significant problem in access to health care during a time of rapidly changing transportation technology.


2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Nichole Nidey ◽  
George L. Wehby

Background: There is a growing interest in health services research of orofacial clefts (OFC) in the United States. The objective of this study is to summarize the empirical knowledge to date about barriers to health care for children with OFC. Methods: We completed a systematic literature review to identify articles on barriers to health care for children with OFC in the United States. Pubmed, Embase, CINAHL, and Medline were searched from their dates of origin through June 2018 using a combination of key terms related to access and barriers to health care. Case reports and studies of populations outside of the United States were excluded. Results: 4079 publications were identified using our search strategy. After a title and abstract review, 18 were included in our review as they met inclusion criteria. These studies examined health care costs, health insurance coverage, access to team care, geographic barriers, adequacy of training of community-based providers in providing services to children with OFC, and socioeconomic and demographic factors. The key findings indicate much higher health care costs for children with OFC than unaffected children early in childhood, racial/ethnic disparities in certain access measures, and inadequate insurance coverage, distance to teams, and inadequate training of community-based providers in OFC-specific services as potential areas of concern. Except for studies on health care costs, the evidence is largely based on relatively small and primarily descriptive studies. Conclusions: The extant literature documents high health care costs for OFC treatments and suggests inadequate insurance coverage, long distance to cleft teams, and racial/ethnic disparities as critical factors related to access. We discuss multiple future research priorities. Among these, understanding the impacts of variation between states in mandates for private insurance benefits and generosity in Medicaid coverage on access to care as well as effects of differences in provider reimbursements are particularly understudied areas that can be meaningful for policymaking aimed at improving access and health outcomes of children with OFC. Examining access throughout childhood and later in life and employing robust designs and population-representative data are also important research and methodological extensions of the current literature.


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