Access to care disparities: Race/Ethnicity and Gender Perspective

This study blends a "gender" perspective with different racial and ethnic group identification such Hispanics and non-Hispanic-Whites to analyze the health care access disparities. According to Kaiser 2009, studies adopt two ways to examine health care disparities: studies either didn’t take into account gender differences (combined men and women) while analyzing racial and ethnic health care disparities, or didn’t take into account the racial and ethnic differences while analyzing the gender health care disparities. These historical approaches might have missed important opportunities to detect the causes of disparities (i.e miss some of significance in variations) or mask some of the interesting results.  I combined Medical Expenditure Panel Survey 2011, 2010 and 2009 to analyze disparities between two main groups: 1) Between different ethnicity and same gender: Hispanic women and Non-Hispanic-White women, Hispanic men and Non-Hispanic-White men, 2) Between same ethnicity and different gender:  Non-Hispanic-White women and men, Hispanic women and men. I expand commonly used predisposing factors and include variables reflecting attitudes and beliefs regarding health care. Further, I measure insurance coverage as fractions which capture the duration and type of health insurance coverage that each respondent had during the full year. By this way, I was able to measure the impact of duration and the type of coverage on access to care. I combine health insurance and having regular source of care into a single outcome variable to measure full access to care, for which disparities may be highly pronounced. Measures of access to care are binary, thus I use Probit Decomposition to identify which of the explanatory variables contributed to this gap significantly. I find that a majority of women and non-Hispanic-White men report having a regular source of care and full access to care. 48 percent of Hispanic men reports having a regular source of care and only 37 percent have full access to care. Mean duration of private health insurance coverage is about 8.5 months for non-Hispanic-Whites, compared to 5 months for Hispanics. “Between different ethnicity and same gender” decomposition results suggest that, most of the differences in access to care are explained by observed factors. This finding indicates that if both group had the same observed characteristics, then they would have the same probability of having access to care. For instance, non-Hispanic-White women are 15 percent more likely to have access to care than Hispanic women. 74 percent of this difference is due to difference in observed characteristics. Precisely, having private insurance explains 80 percent of the difference in access to care.  Similar trend is observed for non-Hispanic-White men and Hispanic men. However, “Between same ethnicity and different gender” decomposition results suggest that women are up 18 percent more likely to have an access to care, and 76 percent of this difference is due to unobserved characteristics. High constant suggest that women’s preference to have an access to care shifted more than men’s preferences. Thus findings of this study suggest introducing gender perspective is important to explain differences in access to care behaviors.