title: Difference, disparity, and disability: a comparison of health, insurance coverage, and health service use on the basis of race/ethnicity among US adults with disabilities, 2006-2008.
abstract: BACKGROUND
  In the United States, research on health disparities has begun to include people with disabilities as a minority population. However, there is a gap in our knowledge of whether, and to what extent, racial and ethnic disparities may affect the health or health care access of people with disabilities.
  
  
  OBJECTIVE
  We examined potential disparities in overall health, insurance coverage status, and health service use between non-Hispanic whites, non-Hispanic blacks, and Hispanics, among a nationally representative US sample of adults with and without disabilities (N=63,257), using both bivariate and multivariate methods. We tested 2 definitions of disparity.
  
  
  RESULTS
  Under the more conservative definition, we confirmed the presence of both racial and ethnic disparities in overall health, total annual health care visits, and the percentage reporting no doctor visit during the year among people with less severe disabilities; Hispanics also evidenced a disparity in rates uninsured relative to non-Hispanic whites in this group. Racial/ethnic disparities were less common among persons with more severe disabilities that affected activities of daily living or instrumental activities.
  
  
  CONCLUSIONS
  We conclude that the reduction of disparities between the populations of people with and without disabilities will require specific attention to racial and ethnic disparities in health, insurance coverage, and service use.
authors.affiliation: *The Heller School for Social Policy and Management, Brandeis University, Waltham, MA †Rehabilitation Medicine Department, Clinical Research Center, National Institutes of Health, Bethesda, MD.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Gulley
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Rasch
authors.forename: Leighton
authors.initials: L
authors.lastname: Chan
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006302:Health Services Research; D006304:Health Status; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D044469:Racial Groups / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States