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

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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.

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Funding

This research was supported by National Institute on Minority Health and Health Disparities (U54MD000214, PI: Gaskin).

Author information

Authors and Affiliations

  1. Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Kitty S. Chan, Roland J. Thorpe Jr & Darrell J. Gaskin

  2. Medstar Health Research Institute, 3800 Reservoir Rd., NW, Gorman 3056, Washington, DC, 20007, USA

    Kitty S. Chan

  3. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Megha A. Parikh & Darrell J. Gaskin

  4. Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Roland J. Thorpe Jr

Authors
  1. Kitty S. Chan
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  2. Megha A. Parikh
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  3. Roland J. Thorpe Jr
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  4. Darrell J. Gaskin
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Corresponding author

Correspondence to Kitty S. Chan.

Ethics declarations

The study has been reviewed by the Institutional Review Board at Johns Hopkins Bloomberg School of Public Health and determined to be Not Human Subjects Research.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Chan, K.S., Parikh, M.A., Thorpe, R.J. et al. Health Care Disparities in Race-Ethnic Minority Communities and Populations: Does the Availability of Health Care Providers Play a Role?. J. Racial and Ethnic Health Disparities 7, 539–549 (2020). https://doi.org/10.1007/s40615-019-00682-w

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  • DOI: https://doi.org/10.1007/s40615-019-00682-w

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