title: Perceived access to health care and its influence on the prevalence of behavioral risks among urban African Americans.
abstract: BACKGROUND
  Individuals who have difficulty gaining access to health care may delay seeking and obtaining treatment, underutilize preventive health care services, and may have a high prevalence of chronic disease risks. This report examines participant perception of the level of difficulty encountered when obtaining medical care and its influence on the prevalence of chronic disease behavioral risks among urban African Americans.
  
  
  RESULTS
  We found a significantly higher prevalence of current cigarette smoking and alcohol consumption among African Americans who reported that they experienced difficulty in obtaining medical care than among those who did not. Compared to those who experienced no difficulty obtaining care, participants who perceived a high level of difficulty in obtaining care were less likely to have had a physical exam in the past year and to have seen the same doctor when services were obtained.
  
  
  CONCLUSIONS
  The perception of a high level of difficulty obtaining health care may be associated with a higher prevalence of behavioral risks for chronic disease. The limited data suggest a need to more closely examine the perception of health care accessibility and its relationship to health services utilization and the prevalence of chronic disease behavioral risks.
authors.affiliation: Johns Hopkins University, Department of Epidemiology, School of Hygiene and Public Health, Baltimore, Maryland, USA. shaversv@mail.nih.gov
authors.forename: Vickie L
authors.initials: VL
authors.lastname: Shavers
authors.forename: Sharada
authors.initials: S
authors.lastname: Shankar
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Alberg
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000428:Alcohol Drinking / Q000208:ethnology; D015992:Body Mass Index; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010808:Physical Examination; D012044:Regression Analysis; D012309:Risk-Taking; D012907:Smoking / Q000208:ethnology