Income Inequities and Medicaid Expansion are Related to Racial and Ethnic Disparities in Delayed or Forgone Care Due to Cost

Bibliographic Data

ID9103595
AuthorsCheryl R Clark (0000-0001-6782-6382, The Center for Community Health and Health Equity, Brigham and Women’s Hospital, corresponding author), Mark J Ommerborn (The Center for Community Health and Health Equity, Brigham and Women’s Hospital, corresponding author), Brent A Coull (0000-0002-1808-4156, Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA), Do Quyen Pham (The Center for Community Health and Health Equity, Brigham and Women’s Hospital, corresponding author), Jennifer S Haas (0000-0001-7227-851X, Division of General Medicine and Primary Care, Brigham and Women’s Hospital)
Year2016
Volume54
Issue6
Pages555-561
Publication date2016-06-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000525
PMID26974677
OpenAlexW2330689766
LanguageEN
Citations received4
References cited16

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. 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. 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. 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

Behavioral Risk Factor Surveillance System · Demographic economics · Economic growth · Economics · Environmental health · Ethnic group · Health care · Health equity · Medicaid · Political science · Population · Poverty · Public health · Social determinants of health · Geriatric Care and Nursing Homes · Health disparities and outcomes · Healthcare Policy and Management · Medicine · Nursing · Gerontology

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