Health Care Disparities in Race-Ethnic Minority Communities and Populations: Does the Availability of Health Care Providers Play a Role?

J Racial Ethn Health Disparities. 2020 Jun;7(3):539-549. doi: 10.1007/s40615-019-00682-w. Epub 2019 Dec 16.

Abstract

Objectives: To examine disparities in use and access to different health care providers by community and individual race-ethnicity and to test provider supply as a potential mediator.

Data sources: National secondary data from 2014 Medical Expenditure Panel Survey, 5-year estimates (2010-2014) from American Community Survey, and 2014 InfoUSA.

Study design: Multiple logistic regression models examined the association of community and individual race-ethnicity with reported health care visits and access. Mediation analyses tested the role of provider supply.

Data extraction methods: Individual-level survey data were linked to race-ethnic composition and health business counts of the respondent's primary care service area (PCSA).

Principal findings: Minority PCSAs are significantly and independently associated with lower odds of having a visit to a physician assistant/nurse practitioner, dentist, or other health professionals and having a usual care provider (all p < 0.05). Few significant associations were observed for integrated PCSAs or for health provider supply. A modest mediation effect for provider supply was observed for travel time to usual care provider and visit to other health professionals.

Conclusions: Use of a range of health services is lower in minority communities and individuals. However, provider supply was not an important explanatory factor of these disparities.

Keywords: Ethnic; Health care disparities; Health care provider supply; Racial; Segregation.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Ethnicity / statistics & numerical data*
  • Female
  • Health Care Surveys / statistics & numerical data*
  • Health Personnel / statistics & numerical data*
  • Health Services Accessibility / statistics & numerical data*
  • Healthcare Disparities / ethnology*
  • Hispanic or Latino / psychology*
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Minority Groups / statistics & numerical data*
  • United States / ethnology