Health Care Utilization Among Post-Stroke Women: Associations with Perceived Racism.

Abstract

Purpose: Post-stroke health care is crucial for recovery and preventing complications. This study explored the association between perceived racism and health care utilization among post-stroke women, highlighting the disparate utilization patterns of marginalized racial/ethnic women. Methods: The 2022 Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System Survey was used to characterize health care utilization among women with stroke diagnoses across different racial groups: White, Black, Hispanic, and Asian/Asian, Islander, Alaska Native/Other/Multiracial. Logistic regression analysis characterized the association between three types of health care utilizations-having a health insurance plan, a health care provider, and receiving a routine checkup-and perceived race-based treatment in the medical sector. Results: The sample included 10,184 post-stroke women: 75.01% White, 12.42% Black, 6.77% Hispanic, and 5.80% Asian/AIAN/Other/multiracial. Only 2.95% of White women reported worse treatment, compared with 10.74% of Black, 13.19% of Asian/AIAN/Other/multiracial, and 8.85% of Hispanic women. Regression analysis revealed that Hispanic women (odds ratio [OR] = 0.61, confidence interval [CI] = 0.17, 0.84) were less likely to have a health plan, though those receiving similar or better treatment had higher odds (OR = 1.55, CI = 1.62, 3.90). Black women were less likely to have a routine checkup (OR = 0.51, CI = 0.14, 0.77), but those receiving similar or better treatment had higher odds (OR = 2.72, CI = 1.64, 11.63). Women from other racial/ethnic groups, Black, and Hispanic women had lower odds of having a personal provider (ORs ranging from 0.17 to 0.69), though those receiving similar or better treatment had higher odds (ORs ranging from 1.79 to 3.39). Conclusions: Perceived differences in treatment in the medical sector among marginalized post-stroke women were significantly associated with lower health care utilization.