Differences in Health Care Access and Satisfaction Across Intersections of Race/Ethnicity and Sexual Identity

Bibliographic Data

ID21613370
AuthorsRodman E Turpin (0000-0003-0457-5584, R.E. Turpinis assistant research professor, Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, College Park, Maryland., corresponding author), Ellesse-Roselee L Akré (E.-R.L. Akréis assistant professor, The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.), Ellesse-Roselee Akré (0000-0002-2380-6344, Dartmouth Institute for Health Policy and Clinical Practice), Natasha D Williams (0000-0001-6926-095X, N.D. Williamsis a PhD student, Department of Family Science, School of Public Health, University of Maryland, College Park, College Park, Maryland.), Bradley O Boekeloo (0000-0002-4182-6613, B.O. Boekeloois professor, Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, College Park, Maryland.), J N Fish (0000-0001-9280-6156, J.N. Fishis assistant professor, University of Maryland Prevention Research Center, University of Maryland, College Park, College Park, Maryland.)
Year2021
Volume96
Issue11
Pages1592-1597
Publication date2021-11-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAcademic Medicine (JOURNAL)
Journal identifiersISSN: 1040-2446 • E-ISSN: 1938-808X
PublisherOxford University Press (OUP) (PUBLISHER)
DOI10.1097/acm.0000000000004243
PMID34261863
OpenAlexW3181980509
LanguageEN
Citations received7
References cited17

PURPOSE: Racial/ethnic and sexual minorities experience numerous health disparities compared with their White and heterosexual counterparts, which may be exacerbated when these social identities intersect. The authors tested for differences in health care access and satisfaction across intersections of sexual identity and race/ethnicity. METHOD: A cross-sectional secondary data analysis of the 2012-2018 waves of the Association of American Medical Colleges biannual online Consumer Survey of Health Care Access was conducted. This survey captures a national sample of U.S. adults who reported needing health care in the past 12 months. The analytic sample included 29,628 participants. Sixteen possible combinations of sexual identity and race/ethnicity were examined. Health care access and satisfaction were measured with 10 items and an index created from these items. Cumulative prevalence ratios (PRs) for the index and PRs across sexual identity, both individually and in combination with race/ethnicity, for each health care access and satisfaction item were generated. RESULTS: Compared with White heterosexuals, all other groups had significantly more barriers to care before adjustment. The greatest barriers were observed among non-Hispanic Asian/Pacific Islander/Hawaiian gay/lesbian (unadjusted PR = 3.08; 95% confidence interval [CI]: 2.45, 3.88; adjusted PR = 2.01; 95% CI: 1.59, 2.53), non-Hispanic Black bisexual (unadjusted PR = 2.73; 95% CI: 2.28, 3.27; adjusted PR = 1.83; 95% CI: 1.52, 2.20), non-Hispanic Black other sexual identity (unadjusted PR = 2.27; 95% CI: 1.69, 3.06; adjusted PR = 2.07; 95% CI: 1.53, 2.78), and Hispanic/Latino other sexual identity (unadjusted PR = 2.06; 95% CI: 1.60, 2.65; adjusted PR = 1.39; 95% CI: 1.08, 1.79) participants. CONCLUSIONS: Persons of both racial/ethnic and sexual minority status generally had less health care access and satisfaction than White heterosexuals. An intersectional perspective is critical to achieving equity in quality health care access

Confidence interval · Ethnic group · Health care · Health equity · Human sexuality · Lesbian · National Survey of Family Growth · Pacific islanders · Political science · Population · Public health · Sexual identity · Sexual minority · Sexual orientation · Sociology · Cultural Competency in Health Care · Demography · Gender Studies · LGBTQ Health, Identity, and Policy · Medicine · Nursing · Patient Satisfaction in Healthcare · Psychology · Social Psychology · Gerontology