title: Racial disparities in medical expenditures within body weight categories.
abstract: BACKGROUND
  Despite federal guidelines calling for the reduction of obesity and elimination of health disparities, black-white differences in obesity prevalence and in medical expenditures and utilization of health care services persist.
  
  
  OBJECTIVE
  To examine black-white differences in medical expenditures and utilization of health care services (office-based visits, hospital outpatient visits, ER visits, inpatient stays and prescription medication) within body weight categories.
  
  
  METHODS
  This study used data from the 2006 Medical Expenditures Panel Survey (MEPS) and included 15,164 non-Hispanic white and non-Hispanic black adults. We used a standard two-part econometric model to examine black-white differences in how expenditures (total annual medical expenditures and expenditures for each type of service) vary within body weight categories.
  
  
  RESULTS
  Blacks in each weight category were less likely to use any medical care than their white counterparts, even after controlling for socio-demographic characteristics, perceived health status, health conditions and health beliefs. Among those who received medical care, there is no significant difference in the total amount spent on care between blacks and whites. Compared to whites, blacks in each body weight category were significantly less likely to use office-based visits, hospital outpatient visits, and medications. Among those who used medications, blacks had significantly lower expenditures than whites. Blacks in obese class II/III were significantly less likely to have any medical expenditures on inpatient care than their white counterparts.
  
  
  CONCLUSIONS
  Black-white racial differences in total medical expenditures were observed in each body weight category and were significantly different in the obese I class, overweight, and healthy weight categories. Obese blacks also spent a smaller amount than obese whites--the insignificance might be due to the smaller sample size. These differences cannot be fully explained by socio-demographics, health conditions, or health beliefs. Black-white differences in medical expenditures may be largely due to relatively inexpensive types of care (office-based visits, outpatient care, medication) rather than more costly ones (inpatient care, ER).
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. sma@jhsph.edu
authors.forename: Sai
authors.initials: S
authors.lastname: Ma
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Frick
authors.forename: Sara
authors.initials: S
authors.lastname: Bleich
authors.forename: Lisa
authors.initials: L
authors.lastname: Dubay
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data*; D054625:Healthcare Disparities; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D017059:Models, Econometric; D009765:Obesity / Q000208:ethnology* / Q000628:therapy; D009819:Office Visits / Q000706:statistics & numerical data; D050177:Overweight / Q000208:ethnology / Q000628:therapy; D012959:Socioeconomic Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult