The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #57188

Ami M. Shah, MPH¹, Cynthia L. Williams, MS², and Steven Whitman, PhD¹. (1) Sinai Health System, Sinai Urban Health Institute, California at 15th Street, K439, Chicago, IL 60608, 773-257-6569, shaam@sinai.org, (2) Sinai Health System, Sinai Community Institute, 2653 W. Ogden, Chicago, IL 60608

The recent Institute of Medicine report, Care Without Coverage, describes how the lack of insurance can lead to delays in seeking care, inappropriate use of services, increased risk of developing serious health conditions, and ultimately, of premature death. National estimates of uninsurance rates indicate large racial and ethnic disparities, where 30% of Hispanics and 17% of non-Hispanic Blacks are uninsured compared to 11% of non-Hispanic Whites.

A face-to-face health survey was implemented in 1700 randomly selected households in six racially and ethnically diverse community areas in Chicago, one of the most segregated cities in the U.S. One goal of this survey was to examine the extent to which health insurance coverage affects the utilization of health services and associated risk factors of ill health in these communities.

Preliminary data reveals that compared to only 7% of the people in predominantly White community, 36% of the people from the predominately Black community and 53% from the Mexican community were uninsured. These community specific estimates are alarmingly higher than the national estimates and suggest greater health disparities in accessing and utilization services.

Our presentation will describe the demographic and SES correlates of these uninsurance rates. We will also examine the social determinants of health-seeking behavior by considering whether people have a usual source of care, face barriers in accessing services or prescribed medications, and whether they received timely preventative health services. Finally, we will discuss the implications of these findings for reducing racial and ethnic disparities in health by the year 2010.

Learning Objectives:

Participants in this session will be able to:
• Recognize the need for community level data when examining access to care;
• Articulate racial and ethnic disparities in health outcomes associated with insurance status;
• Apply the social context of health in ethnic and racial minorities to develop effective interventions and guide improved health policies.

Keywords: Health Insurance, Health Disparities

Related Web page: www.sinai.org/urban/originalresearch/index.asp

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.