title: Disparities in perceptions of healthcare access in a community sample.
abstract: Disparities in health status persist for many sociodemographic groups in the United States. An understanding of barriers to healthcare access and utilization can assist community-based initiatives in developing strategies to improve the health of minority and low-income populations. Using self-reported information from 3014 community residents, a factor analysis was conducted that defined barriers to healthcare by 4 dimensions: (1) time and competing priorities, (2) convenience and availability, (3) healthcare utilization, and (4) healthcare affordability. Differential effects of demographics were observed on all factors. Racial disparities were found where African Americans experienced more problems based on the convenience and availability of services (P < .02) than did whites, after controlling for income, education, age, and marital status. In addition, gender differences showed that women experienced greater difficulty with time and competing priorities than men (P < .001); however, women experienced fewer problems related to utilization (P < .001). Of the covariates, income was significant (P < .01) on 3 of the 4 indicators. This study points to the need to develop interventions that address the unique challenges faced by different population groups to ensure timely healthcare. In addition, the reduction of economic disparities should be considered as an important strategy to improve public health.
authors.affiliation: Department of Internal Medicine, Meharry Medical College, Nashville, TN 37208, USA. celialarson@comcast.net
authors.forename: Celia O
authors.initials: CO
authors.lastname: Larson
authors.forename: David
authors.initials: D
authors.lastname: Schlundt
authors.forename: Kushal
authors.initials: K
authors.lastname: Patel
authors.forename: Linda
authors.initials: L
authors.lastname: McClellan
authors.forename: Margaret
authors.initials: M
authors.lastname: Hargreaves
mesh_terms: D000328:Adult; D000368:Aged; D001290:Attitude; D006297:Health Services Accessibility; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups; D011203:Poverty; D011795:Surveys and Questionnaires; D013714:Tennessee