Racial and Ethnic Disparities in Womens Health Coverage and Access to Care

1
Racial and Ethnic Disparities in Womens Health
Coverage and Access to Care

• Alina Salganicoff, Ph.D.
• Vice President
• Director, Womens Health Policy
• Henry J. Kaiser Family Foundation
• AMA Womens Congress
• March 27, 2004
• Washington DC

2
Potential Sources of Disparities in Care

• Patient-Level
• Patient preferences
• Treatment refusal
• Care seeking behaviors and attitudes
• Biologically based differences in clinical
  presentation
• Healthcare Systems-Level
• Lack of interpretation and translation services
• Time pressures on physicians
• Availability and mix of health providers
• Fragmentation in systems of financing and
  delivery of care
• Provider-Level
• Bias
• Clinical uncertainty
• Beliefs/stereotypes about behavior or health of
  patients

Source IOM, 2002. Unequal Treatment
Confronting Racial and Ethnic Disparities in
Health Care.
3
Selected Demographic Characteristics of Women,
2001
Note Includes women ages 18 to 64. The federal
poverty level was 11,610 for a family of two in
2001. Source Henry J. Kaiser Family Foundation,
Kaiser Womens Health Survey, 2001.
4
Differences in Health Status, by Race/Ethnicity
Percent reporting




Note Includes women ages 18 to 64.
Significantly different from reference group,
white women, at plt .05. Limitations in
activity are due to a disability, handicap, or
chronic disease that keeps respondents from
participating fully in school, work, housework,
or other activities. Source Henry J. Kaiser
Family Foundation, Kaiser Womens Health Survey,
2001.
5
Disparities in Insurance Coverage
6
Health Insurance Coverage by Race/Ethnicity
Note Includes women ages 18 to 64. Source
Henry J. Kaiser Family Foundation, Kaiser Womens
Health Survey, 2001.
7
Health Insurance Gaps by Race/Ethnicity


Notes Includes women ages 18 to 64.
Significantly different from reference group,
white women, at plt .05. Unstable coverage is
defined as lack of continuous insurance coverage
during past one year. Source Henry J. Kaiser
Family Foundation, Kaiser Womens Health Survey,
2001.
8
Interaction with Health Care System
9
Womens Connection to the Health Care System by
Race/Ethnicity


Notes Includes women ages 18 to 64.
Significantly different from reference group,
white women at plt.05 Based on women who have
reported having a regular health care
provider Source Henry J. Kaiser Family
Foundation, Kaiser Womens Health Survey, 2001.
10
Number and Specialty of Regular Providers
Notes Includes women ages 18 to 64 who have
had a check-up in last two years. Source Henry
J. Kaiser Family Foundation, Kaiser Womens
Health Survey, 2001.
11
Where Women Receive Medical Care, by
Race/Ethnicity





Notes Includes women ages 18 to 64 who have
had a check-up in last two years.
Significantly different from reference group,
white women at plt.05 Source Henry J. Kaiser
Family Foundation, Kaiser Womens Health Survey,
2001.
12
Access and Utilization
13
Problems Accessing Care, by Race/Ethnicity
Percent reporting in past year



Note Includes women ages 18 to 64.
Significantly different from reference group,
white women, at plt .05. Source Henry J. Kaiser
Family Foundation, Kaiser Womens Health Survey,
2001.
14
Reasons for Delays of Care in Past Year
Percent reporting





Notes Includes women ages 18 to 64.
Significantly different from reference group,
white women, at plt .05. Among women with
children. Source Henry J. Kaiser Family
Foundation, Kaiser Womens Health Survey, 2001.
15
Dental and Vision Care in Past Two Years
Notes Includes women ages 18 to 64 Source
Henry J. Kaiser Family Foundation, Kaiser Womens
Health Survey, 2001.
16
Use of Preventive Services, by Race/Ethnicity
Percent who have not received test in past two
years



Notes Includes women ages 18 to 64 except for
mammogram. Significantly different from
reference group, white women at plt.05
Includes women ages 40 to 64. Source Henry J.
Kaiser Family Foundation, Kaiser Womens Health
Survey, 2001.
17
Communication with Providers
18
Problems Communicating with Physicians
Percent reporting


Notes Includes women ages 18 to 64.
Significantly different from reference group,
white women at plt.05 In past year. In past
two years. Source Henry J. Kaiser Family
Foundation, Kaiser Womens Health Survey, 2001.
19
Personal Involvement in Health Care Decisions
Share of women involved in health care decision
as much as wanted
Source The Commonwealth Fund 2001 Health Care
Quality Survey.
20
Able to Understand Doctors Instructions, by
Race/Ethnicity
Percentage of women reporting it very easy to
understand information from doctors office
Source The Commonwealth Fund 2001 Health Care
Quality Survey.
21
Following Doctors Advice, by Race/Ethnicity
Among women who have had a doctor visit in past 2
years. Source The Commonwealth Fund 2001 Health
Care Quality Survey.
22
Addressing Disparities
23

Raising Awareness About Disparities
www.kff.org/whythedifference