{"title":"Racial and Ethnic Disparities in Access to Care during the Early Years of Affordable Care Act Implementation in California.","authors":"S. Charles, A. McEligot","doi":"10.32398/CJHP.V16I1.2122","DOIUrl":null,"url":null,"abstract":"Background and Purpose\nFollowing the Affordable Care Act (ACA) health insurance expansions, this study asks: did racial/ethnic group disparities in access to care remain? And specifically, did Latinos experience worse access to care after the ACA expansions compared to other racial/ethnic groups?\n\n\nMethods\nDataset: 2015 California Health Interview Survey (n=21,034; N=29,083,000). Participants: Adults, ages 18 and older, in California. Analyses: Bivariate chi-square tests and logistic multivariate regressions, including stratification by insurance.\n\n\nResults\nBivariate tests showed associations between racial/ethnic group and access to care. Latinos had lowest rates of having a usual source of care among uninsured (49.5%) and job-based coverage (85.2%). One-fifth of uninsured non-Latino whites (21%) report foregoing needed care. In the multivariate models, non-Latino whites had significantly higher odds of having a usual source of care (OR=1.32; p<0.05), but also of foregoing needed care (OR=1.43; p<0.05), than Latinos. Asian Americans had significantly lower odds of visiting a doctor in the past year (OR=0.65; p<0.05) than Latino adults.\n\n\nConclusion\nFollowing the ACA, disparities among racial/ethnic groups have become more complex. While Latino adults still have lower rates of having a usual source of care, Asian American adults have low rates of visiting a doctor, and non-Latino whites have high rates of foregoing needed care. Further research into the causes of difficulties in accessing care is needed, as health insurance expansions did not create health equity in solving access to care problems.","PeriodicalId":87431,"journal":{"name":"Californian journal of health promotion","volume":"1 1","pages":"36-45"},"PeriodicalIF":0.0000,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Californian journal of health promotion","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.32398/CJHP.V16I1.2122","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
Abstract
Background and Purpose
Following the Affordable Care Act (ACA) health insurance expansions, this study asks: did racial/ethnic group disparities in access to care remain? And specifically, did Latinos experience worse access to care after the ACA expansions compared to other racial/ethnic groups?
Methods
Dataset: 2015 California Health Interview Survey (n=21,034; N=29,083,000). Participants: Adults, ages 18 and older, in California. Analyses: Bivariate chi-square tests and logistic multivariate regressions, including stratification by insurance.
Results
Bivariate tests showed associations between racial/ethnic group and access to care. Latinos had lowest rates of having a usual source of care among uninsured (49.5%) and job-based coverage (85.2%). One-fifth of uninsured non-Latino whites (21%) report foregoing needed care. In the multivariate models, non-Latino whites had significantly higher odds of having a usual source of care (OR=1.32; p<0.05), but also of foregoing needed care (OR=1.43; p<0.05), than Latinos. Asian Americans had significantly lower odds of visiting a doctor in the past year (OR=0.65; p<0.05) than Latino adults.
Conclusion
Following the ACA, disparities among racial/ethnic groups have become more complex. While Latino adults still have lower rates of having a usual source of care, Asian American adults have low rates of visiting a doctor, and non-Latino whites have high rates of foregoing needed care. Further research into the causes of difficulties in accessing care is needed, as health insurance expansions did not create health equity in solving access to care problems.