Longstanding disparities in preventive care between whites and African-Americans are narrowing, but Hispanics continue to receive significantly less preventive care than both groups, according to a study published by the Center for Studying Health System Change (HSC).
African-Americans now visit physicians and receive mammograms at the same rate as whites. In 1999, the percentage of Hispanics who saw a physician also increased. Yet, the study shows Hispanics continue to receive much less preventive care than whites and African-Americans, with little or no improvement in this area since 1997.
Across the board, more Americans saw a doctor at least once in 1999 than in 1997. About 80 percent of whites and African-Americans and 68 percent of Hispanics reported seeing a physician in the last year. While Hispanics still lag behind, this group was 6 percent more likely to report having seen a doctor in 1999 than two years earlier.
"The gap in doctor visits between Hispanics and others may help to explain why Hispanics lag behind whites and African-Americans in receiving preventive services," said Lee Hargraves, study author and HSC researcher. "Failure to receive such services can contribute to the persistence of health disparities among racial and ethnic minorities."
The HSC study examined racial differences in the receipt of common preventive care services, including mammograms, smoking cessation and flu shots. The findings include:
Some 74 percent of African-American and white women over age 50 received mammograms in 1999, compared with 71 percent of Hispanic women. The jump for African-American women was 8 percentage points in a two-year period.
Approximately 38 percent of whites and 34 percent of African-Americans who smoke were advised to stop by their physicians, compared to 25 percent of Hispanics in 1999. The disparity between Hispanics and others increased from 1997, with whites and African-Americans making significant gains while the rate of Hispanics counseled by a physician to stop smoking remained stagnant.
Flu-shot rates for Hispanics (56 percent) and African-Americans (51 percent) remained flat, but there was a statistically significant increase in the percentage of whites that received flu vaccinations - approaching seven in ten older white persons. This finding raises a question regarding minorities, particularly African-Americans' distrust of the health system, given that all persons 65 and older are entitled to flu shots under Medicare.
"Success in closing the gap between African-Americans and whites is likely attributable to both government and private-sector efforts," said Paul B. Ginsburg, HSC president. "But the results for Hispanics present a continuing challenge. To surmount language and cultural barriers - 48 percent of Hispanics were born outside this country - policy makers need to explore innovative approaches to reducing health disparities for this growing population of Americans."
This study is based on HSC's 1997 and 1999 Household Surveys. The measures in the survey related to preventive care apply to specific conditions or subgroups in which disparities are known to exist and where benefits of preventive care have been demonstrated. Three preventive care indicators were examined for the HSC Issue Brief #34 "Race, Ethnicity and Preventive Services: No Gains for Hispanics."
The Household Survey was conducted as part of HSC's Community Tracking Study (CTS). The CTS includes semiannual surveys of physicians, consumers and employers to track trends in the health care system as well as site visits to 12 communities. The CTS surveys focus on 60 nationally representative communities throughout the United States and include responses from approximately 60,000 persons. HSC has just launched its third round of the CTS with previous surveys conducted in 1996-1997 and 1998-1999.
Race, Ethnicity and Preventive Services: No Gains for Hispanics Issue Brief #34
J. Lee Hargraves
Three years ago, the Clinton administration initiated multiple efforts to identify and eliminate health disparities among various populations, including ethnic minority groups. Recent findings from the Community Tracking Study Household Survey show that between 1997 and 1999 there was an increase in the percentage of white and African American persons receiving preventive care—such as mammography screening among women and physicians counseling cigarette smokers to quit—but that there was no such increase in preventive measures for Hispanics. If policy makers want to remove disparities in health status based on race and ethnicity, they need to promote preventive care for minorities and monitor progress by regularly measuring preventive care indicators. This Issue Brief focuses on change in key preventive care indicators between 1997 and 1999.
Click below for complete Brief (Adobe Acrobat required):