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Trends in Differences in Health Status and Health Care Access and Affordability by Race and Ethnicity in the United States, 1999-2018.
- Source :
- JAMA: Journal of the American Medical Association; 8/17/2021, Vol. 326 Issue 7, p637-648, 12p
- Publication Year :
- 2021
-
Abstract
- <bold>Importance: </bold>The elimination of racial and ethnic differences in health status and health care access is a US goal, but it is unclear whether the country has made progress over the last 2 decades.<bold>Objective: </bold>To determine 20-year trends in the racial and ethnic differences in self-reported measures of health status and health care access and affordability among adults in the US.<bold>Design, Setting, and Participants: </bold>Serial cross-sectional study of National Health Interview Survey data, 1999-2018, that included 596 355 adults.<bold>Exposures: </bold>Self-reported race, ethnicity, and income level.<bold>Main Outcomes and Measures: </bold>Rates and racial and ethnic differences in self-reported health status and health care access and affordability.<bold>Results: </bold>The study included 596 355 adults (mean [SE] age, 46.2 [0.07] years, 51.8% [SE, 0.10] women), of whom 4.7% were Asian, 11.8% were Black, 13.8% were Latino/Hispanic, and 69.7% were White. The estimated percentages of people with low income were 28.2%, 46.1%, 51.5%, and 23.9% among Asian, Black, Latino/Hispanic, and White individuals, respectively. Black individuals with low income had the highest estimated prevalence of poor or fair health status (29.1% [95% CI, 26.5%-31.7%] in 1999 and 24.9% [95% CI, 21.8%-28.3%] in 2018), while White individuals with middle and high income had the lowest (6.4% [95% CI, 5.9%-6.8%] in 1999 and 6.3% [95% CI, 5.8%-6.7%] in 2018). Black individuals had a significantly higher estimated prevalence of poor or fair health status than White individuals in 1999, regardless of income strata (P < .001 for the overall and low-income groups; P = .03 for middle and high-income group). From 1999 to 2018, racial and ethnic gaps in poor or fair health status did not change significantly, with or without income stratification, except for a significant decrease in the difference between White and Black individuals with low income (-6.7 percentage points [95% CI, -11.3 to -2.0]; P = .005); the difference in 2018 was no longer statistically significant (P = .13). Black and White individuals had the highest levels of self-reported functional limitations, which increased significantly among all groups over time. There were significant reductions in the racial and ethnic differences in some self-reported measures of health care access, but not affordability, with and without income stratification.<bold>Conclusions and Relevance: </bold>In a serial cross-sectional survey study of US adults from 1999 to 2018, racial and ethnic differences in self-reported health status, access, and affordability improved in some subgroups, but largely persisted. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00987484
- Volume :
- 326
- Issue :
- 7
- Database :
- Complementary Index
- Journal :
- JAMA: Journal of the American Medical Association
- Publication Type :
- Academic Journal
- Accession number :
- 152011157
- Full Text :
- https://doi.org/10.1001/jama.2021.9907