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J Racial Ethn Health Disparities. 2016 Jun;3(2):381-8. doi: 10.1007/s40615-015-0197-5. Epub 2015 Dec 31.

Differences in Problems Paying Medical Bills between African Americans and Whites from 2007 and 2009: the Underlying Role of Health Status.

Author information

1
Department of Health Policy and Management, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL, 33612-3805, USA. jwiltshi@health.usf.edu.
2
Department of Health Management and Policy, School of Public Health and Social Justice, St. Louis University, Saint Louis, MO, USA.
3
Department of Quantitative Health Sciences, University of Massachusetts Medical Center, Worcester, MA, USA.

Abstract

OBJECTIVES:

Although the proportion of people reporting problems paying medical bills has declined in the aftermath of the Great Recession, it is unclear if this decline has been caused by self-rationing of care, particularly among disadvantaged groups. We examined African American-White differences in problems paying medical bills prevalence along with factors which may account for observed differences.

DESIGN:

We used cross-sectional data from 2007 (N = 13,064) and 2010 (N = 11,873) waves of the nationally representative, Health Tracking Household Survey. Logistic regression analyses, accounting for complex survey design and weights, were performed to compute population-based estimates.

RESULTS:

Overall, the prevalence of problems paying medical bills was 18.3 % in 2007 and 19.8 % in 2010. African Americans more frequently reported having problems paying medical bills than Whites. Among African Americans, problems paying medical bills decreased from 30 % in 2007 to 25 % in 2010, which was largely explained by fewer problems reported by those in poor/fair health. Problems paying medical bills significantly declined from 44 % in 2007 to 33 % in 2010 for African Americans in poor/fair health, but remained almost constant for those in good health and very good/excellent health.

CONCLUSION:

Our findings suggest that African Americans in poor health may be rationing or forgoing necessary care as a result of the recession, which could increase existing health disparities and future health spending. Efforts to reduce racial/ethnic disparities may depend on the extent to which the lingering effects of the Great Recession are mitigated.

KEYWORDS:

Great recession; Health status; Medical bill problems; Race/ethnicity

PMID:
26721765
DOI:
10.1007/s40615-015-0197-5
[Indexed for MEDLINE]

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