Racial and ethnic differences in health and health care: lessons from an inner-city patient population actively using heroin and cocaine.
This study describes differences in health care utilization and recorded diagnoses in a racially and ethnically diverse sample of 1175 out-of-treatment patients who screened positive for heroin and cocaine use during an outpatient visit to a drop-in clinic at an urban hospital. Blacks averaged more ED visits than Whites and higher average yearly ED charges than Hispanics (1,991 dollars vs. 1,603 dollars). Charges over two years totaled 6,111,660 dollars. Blacks were most likely to be diagnosed with injury, hypertension, cardiac disease, alcohol abuse/dependency, and sexually transmitted disease, and least likely to be diagnosed with psychiatric disease. Hispanics were most likely to be diagnosed with HIV, dental disease and drug overdoses, and least likely to be injured. Only 34% of this group of drug users was identified with a diagnosis of drug abuse or dependency.
Bernstein
Judith
J
Department of Maternal and Child Health, Brandeis University, USA. jbernste@bu.edu
Bernstein
Edward
E
Shepard
Donald S
DS
Valentine
Anne
A
Heeren
Timothy
T
Winter
Michael
M
Levenson
Suzette
S
Beaston-Blaakman
Aaron
A
Tassiopoulos
Kathryn
K
Hingson
Ralph
R
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D019970:Cocaine-Related Disorders / Q000453:epidemiology / Q000208:ethnology*; D015897:Comorbidity; D003710:Demography; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000208:ethnology; D006331:Heart Diseases / Q000453:epidemiology / Q000208:ethnology; D006556:Heroin Dependence / Q000453:epidemiology / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010146:Pain / Q000453:epidemiology / Q000208:ethnology; D014076:Tooth Diseases / Q000453:epidemiology / Q000208:ethnology; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data