Differences in Problems Paying Medical Bills between African Americans and Whites from 2007 and 2009: the Underlying Role of Health Status
Department of Quantitative Health Sciences
Health Services Administration | Health Services Research
OBJECTIVES: Although the proportion of people reporting problems paying medical bills has declined in the aftermath of the Great Recession, it is unclear if this decline has been caused by self-rationing of care, particularly among disadvantaged groups. We examined African American-White differences in problems paying medical bills prevalence along with factors which may account for observed differences.
DESIGN: We used cross-sectional data from 2007 (N = 13,064) and 2010 (N = 11,873) waves of the nationally representative, Health Tracking Household Survey. Logistic regression analyses, accounting for complex survey design and weights, were performed to compute population-based estimates.
RESULTS: Overall, the prevalence of problems paying medical bills was 18.3 % in 2007 and 19.8 % in 2010. African Americans more frequently reported having problems paying medical bills than Whites. Among African Americans, problems paying medical bills decreased from 30 % in 2007 to 25 % in 2010, which was largely explained by fewer problems reported by those in poor/fair health. Problems paying medical bills significantly declined from 44 % in 2007 to 33 % in 2010 for African Americans in poor/fair health, but remained almost constant for those in good health and very good/excellent health.
CONCLUSION: Our findings suggest that African Americans in poor health may be rationing or forgoing necessary care as a result of the recession, which could increase existing health disparities and future health spending. Efforts to reduce racial/ethnic disparities may depend on the extent to which the lingering effects of the Great Recession are mitigated.
Great recession, Health status, Medical bill problems, Race/ethnicity
DOI of Published Version
J Racial Ethn Health Disparities. 2016 Jun;3(2):381-8. doi: 10.1007/s40615-015-0197-5. Epub 2015 Dec 31. Link to article on publisher's site
Journal of racial and ethnic health disparities
Wiltshire, Jacqueline C.; Elder, Keith; and Allison, Jeroan J., "Differences in Problems Paying Medical Bills between African Americans and Whites from 2007 and 2009: the Underlying Role of Health Status" (2016). University of Massachusetts Medical School Faculty Publications. 1098.