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Income Inequities and Medicaid Expansion are Related to Racial and Ethnic Disparities in Delayed or Forgone Care Due to Cost.
- Source :
-
Medical care [Med Care] 2016 Jun; Vol. 54 (6), pp. 555-61. - Publication Year :
- 2016
-
Abstract
- Background: Monitoring political and social determinants of delayed or forgone care due to cost is necessary to evaluate efforts to reduce racial and ethnic disparities in access to care. Our objective was to examine the extent to which state Medicaid expansion decisions and personal household income may be associated with individual-level racial and ethnic disparities in delayed or forgone care due to cost, at baseline, before the implementation of the Affordable Care Act.<br />Methods: We used 2012 Behavioral Risk Factor Surveillance System survey data to examine racial and ethnic differences in delayed or forgone care due to cost in states that do and do not plan Medicaid expansion. We examined personal household income as a social factor that could contribute to racial and ethnic disparities in delayed or forgone care.<br />Results: We found that personal income differences were strongly related to disparities in delayed or forgone care in places with and without plans to expand Medicaid. In addition, while delayed or forgone care disparities between non-Hispanic whites and non-Hispanic blacks were lowest in places with plans to expand Medicaid access, disparities between non-Hispanic whites and Hispanics did not differ by state Medicaid expansion plans.<br />Conclusions: As access to insurance improves for diverse groups, health systems must develop innovative strategies to overcome social determinants of health, including income inequities, as barriers to accessing care for Hispanic and non-Hispanic blacks. Additional efforts may be needed to ensure Hispanic groups achieve the benefits of investments in health care access.
- Subjects :
- Adolescent
Adult
Black or African American statistics & numerical data
Behavioral Risk Factor Surveillance System
Delayed Diagnosis economics
Delayed Diagnosis statistics & numerical data
Health Services Accessibility economics
Healthcare Disparities economics
Healthcare Disparities ethnology
Hispanic or Latino statistics & numerical data
Humans
Medicaid economics
Middle Aged
United States
White People statistics & numerical data
Young Adult
Health Care Costs statistics & numerical data
Health Services Accessibility statistics & numerical data
Healthcare Disparities statistics & numerical data
Income statistics & numerical data
Medicaid statistics & numerical data
Racial Groups statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1537-1948
- Volume :
- 54
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Medical care
- Publication Type :
- Academic Journal
- Accession number :
- 26974677
- Full Text :
- https://doi.org/10.1097/MLR.0000000000000525