Racial disparities in health care access and cardiovascular disease indicators in Black and White older adults in the Health ABC Study.
OBJECTIVE
Black adults consistently exhibit higher rates of and poorer health outcomes due to cardiovascular disease (CVD) than other racial groups, independent of differences in socioeconomic status (SES). Whether factors related to health care access can further explain racial disparities in CVD has not been thoroughly examined.


METHODS
Using logistic regression, the authors examined racial and health care (i.e., health insurance and access to care) associations with CVD indicators (i.e., hypertension, low ankle-arm index, and left ventricular hypertrophy) in the Health, Aging, and Body Composition Study, a longitudinal study of well-functioning older adults.


RESULTS
Older Black versus White adults had significantly worse health care. Overall, health care reduced the significant association between being Black and CVD only slightly, while race remained strongly associated with CVD after adjusting for demographics, SES, body mass index, and comorbidity.


CONCLUSIONS
Research on health care quality may contribute to our understanding of these disparities.
Rooks
Ronica N
RN
Department of Health and Behavioral Sciences, University of Colorado Denver, P.O. Box 173364, CB 188, Denver, CO 80217-3364, USA. ronica.rooks@cudenver.edu
Simonsick
Eleanor M
EM
Klesges
Lisa M
LM
Newman
Anne B
AB
Ayonayon
Hilsa N
HN
Harris
Tamara B
TB
D000368:Aged; D055109:Ankle Brachial Index; D044383:Black People; D001795:Blood Pressure Determination; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000150:complications / Q000208:ethnology / Q000628:therapy*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006305:Health Status Indicators; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000208:ethnology / Q000209:etiology; D017379:Hypertrophy, Left Ventricular / Q000208:ethnology / Q000209:etiology; D019458:Insurance Coverage; D007348:Insurance, Health; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D017063:Outcome Assessment, Health Care; D019984:Quality Indicators, Health Care; D012959:Socioeconomic Factors; D014481:United States; D044465:White People; D001741:Black or African American