Analysis of the socio-economic factors that contribute to the access of medical care for different ethnic and racial groups

Abstract

My review of the health services literature over the past decade and a half since the release of the Task Force Report revealed significant differences in access to medical care by race and ethnicity within certain disease categories and types of health services. Most studies have varied in their attempts to control for possible explanatory variables most important, SES (or some surrogate measure of social and economic status), insurance coverage, stage or severity of disease, comorbidities, and type and availability of health care services. In some cases, when important variables are controlled, racial and ethnic disparities in access are reduced and may even disappear under certain circumstances. Nonetheless, the literature shows that racial and ethnic disparities persist in significant measure for several disease categories and service types. Findings are irrefutably consistent for certain areas (invasive cardiac care), requires careful interpretation in some areas (cancer and HIV/AIDS), and are muddled in other areas (mental health). In specific health care settings (diabetes care) and under certain circumstances, no racial and ethnic disparities are observed. Altogether, findings from the published literature raise many questions about equity and fairness in health care delivery.