Disentangling the influence of socioeconomic status on differences between African American and white women in unmet medical needs
Department of Quantitative Health Sciences
Medical Subject Headings
Adolescent; Adult; African Americans; Aged; European Continental Ancestry Group; Female; Health Care Surveys; Health Services Needs and Demand; Healthcare Disparities; Humans; Middle Aged; Socioeconomic Factors; United States; Young Adult
Bioinformatics | Biostatistics | Epidemiology | Health Services Research
OBJECTIVES: We sought to disentangle the relationships between race/ethnicity, socioeconomic status (SES), and unmet medical care needs.
METHODS: Data from the 2003-2004 Community Tracking Study Household Survey were used to examine associations between unmet medical needs and SES among African American and White women.
RESULTS: No significant racial/ethnic differences in unmet medical needs (24.8% of Whites, 25.9% of African Americans; P = .59) were detected in bivariate analyses. However, among women with 12 years of education or less, African Americans were less likely than were Whites to report unmet needs (odds ratio [OR] = 0.57; 95% confidence interval [CI] = 0.42, 0.79). Relative to African American women with 12 years of education or less, the odds of unmet needs were 1.69 (95% CI = 1.24, 2.31) and 2.18 (95% CI = 1.25, 3.82) among African American women with 13 to 15 years of education and 16 years of education or more, respectively. In contrast, the relationship between educational level and unmet needs was nonsignificant among White women.
CONCLUSIONS: Among African American women, the failure to recognize unmet medical needs is related to educational attainment and may be an important driver of health disparities, representing a fruitful area for future interventions.
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Citation: Am J Public Health. 2009 Sep;99(9):1659-65. Epub 2009 Jul 16. Link to article on publisher's site