title: Health disparities in later life: a simultaneous equations analysis of utilization.
abstract: OBJECTIVE
  This article examines health disparities between older Blacks/Whites by recognizing the importance of health services utilization. Although previous studies have examined health and utilization independently, this is among the first to (a) model its endogenous relation with utilization, and (b) use a continuous measure for health.
  
  
  METHODS
  Household Component files from Medical Expenditures Panel Survey (MEPS) from 2004 and 2005, with 1,369 observations (1,169 for White and 200 for Black) between the ages of 61-69.
  
  
  METHODS
  The methods employed are two-equation modeling where Medicare eligibility functions as the identification criterion and also as an exogenous shock.
  
  
  RESULTS
  The results show older Blacks continue to remain in poorer health despite access to care and insurance status. The author shows underutilization accounts for some of this observed disparity and offers novel approaches to overcome this issue.
  
  
  CONCLUSIONS
  With the baby-boom cohort approaching retirement, this area of research is timely. This work is also practical because the Department of Health and Human Services has launched various projects examining health care issues for Americans. One major project, Healthy People 2010, provides a "framework for prevention for the Nation [and is] designed to identify the most significant preventable threats to health and to establish national goals to reduce these threats" (http://www.healthypeople.gov/About/). Of the 28 areas, this article complements objectives relating to (a) disability and secondary conditions, and (b) access to quality health services. This article also supports Healthy People 2020, which sets a high priority on access to health care (one of 12 topic areas) and categorizes health disparities as part of the Leading Health Indicators Framework.
authors.affiliation: University of Denver, Denver, CO 80208, USA. andy.sharma@du.edu
authors.forename: Andy
authors.initials: A
authors.lastname: Sharma
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D004608:Eligibility Determination; D005260:Female; D006297:Health Services Accessibility; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D006278:Medicare; D008875:Middle Aged; D008962:Models, Theoretical; D014481:United States; D044465:White People / Q000706:statistics & numerical data*