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. 2002 Nov;94(11):952–962.

Perceived access to health care and its influence on the prevalence of behavioral risks among urban African Americans.

Vickie L Shavers 1, Sharada Shankar 1, Anthony J Alberg 1
PMCID: PMC2594193  PMID: 12442998

Abstract

INTRODUCTION: Individuals who have difficulty gaining access to health care may delay seeking and obtaining treatment, underutilize preventive health care services, and may have a high prevalence of chronic disease risks. This report examines participant perception of the level of difficulty encountered when obtaining medical care and its influence on the prevalence of chronic disease behavioral risks among urban African Americans. RESULTS: We found a significantly higher prevalence of current cigarette smoking and alcohol consumption among African Americans who reported that they experienced difficulty in obtaining medical care than among those who did not. Compared to those who experienced no difficulty obtaining care, participants who perceived a high level of difficulty in obtaining care were less likely to have had a physical exam in the past year and to have seen the same doctor when services were obtained. CONCLUSION: The perception of a high level of difficulty obtaining health care may be associated with a higher prevalence of behavioral risks for chronic disease. The limited data suggest a need to more closely examine the perception of health care accessibility and its relationship to health services utilization and the prevalence of chronic disease behavioral risks.

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Selected References

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  1. Ahluwalia Jasjit S., Dang Kulmeet S., Choi Won S., Harris Kari Jo. Smoking behaviors and regular source of health care among African Americans. Prev Med. 2002 Mar;34(3):393–396. doi: 10.1006/pmed.2001.1004. [DOI] [PubMed] [Google Scholar]
  2. Ayanian J. Z., Weissman J. S., Schneider E. C., Ginsburg J. A., Zaslavsky A. M. Unmet health needs of uninsured adults in the United States. JAMA. 2000 Oct 25;284(16):2061–2069. doi: 10.1001/jama.284.16.2061. [DOI] [PubMed] [Google Scholar]
  3. Bindman A. B., Grumbach K., Osmond D., Vranizan K., Stewart A. L. Primary care and receipt of preventive services. J Gen Intern Med. 1996 May;11(5):269–276. doi: 10.1007/BF02598266. [DOI] [PubMed] [Google Scholar]
  4. Bolen J. C., Rhodes L., Powell-Griner E. E., Bland S. D., Holtzman D. State-specific prevalence of selected health behaviors, by race and ethnicity--Behavioral Risk Factor Surveillance System, 1997. MMWR CDC Surveill Summ. 2000 Mar 24;49(2):1–60. [PubMed] [Google Scholar]
  5. Boysen G., Truelsen T. Looking beyond first-ever stroke incidence. Lancet. 1998 Apr 11;351(9109):1073–1074. doi: 10.1016/S0140-6736(05)79374-0. [DOI] [PubMed] [Google Scholar]
  6. Broderick J., Brott T., Kothari R., Miller R., Khoury J., Pancioli A., Gebel J., Mills D., Minneci L., Shukla R. The Greater Cincinnati/Northern Kentucky Stroke Study: preliminary first-ever and total incidence rates of stroke among blacks. Stroke. 1998 Feb;29(2):415–421. doi: 10.1161/01.str.29.2.415. [DOI] [PubMed] [Google Scholar]
  7. Centers for Disease Control and Prevention (CDC) Annual smoking-attributable mortality, years of potential life lost, and economic costs--United States, 1995-1999. MMWR Morb Mortal Wkly Rep. 2002 Apr 12;51(14):300–303. [PubMed] [Google Scholar]
  8. Coleman E. A., O'Sullivan P. Racial differences in breast cancer screening among women from 65 to 74 years of age: trends from 1987-1993 and barriers to screening. J Women Aging. 2001;13(3):23–39. doi: 10.1300/J074v13n03_03. [DOI] [PubMed] [Google Scholar]
  9. Cornelius L. J. Ethnic minorities and access to medical care: where do they stand? J Assoc Acad Minor Phys. 1993;4(1):16–25. [PubMed] [Google Scholar]
  10. Cornelius Llewellyn J., Smith Pamela L., Simpson Gaynell M. What factors hinder women of color from obtaining preventive health care? Am J Public Health. 2002 Apr;92(4):535–539. doi: 10.2105/ajph.92.4.535. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Coughlin S. S., Uhler R. J. Breast and cervical cancer screening practices among Asian and Pacific Islander women in the United States, 1994-1997. Cancer Epidemiol Biomarkers Prev. 2000 Jun;9(6):597–603. [PubMed] [Google Scholar]
  12. Ettner S. L. The relationship between continuity of care and the health behaviors of patients: does having a usual physician make a difference? Med Care. 1999 Jun;37(6):547–555. doi: 10.1097/00005650-199906000-00004. [DOI] [PubMed] [Google Scholar]
  13. Fong R. L. Violence as a barrier to compliance for the hypertensive urban African American. J Natl Med Assoc. 1995 Mar;87(3):203–207. [PMC free article] [PubMed] [Google Scholar]
  14. George A. R. Accessibility and availability to health care in the African-American community. J Natl Med Assoc. 1991 Sep;83(9):761–764. [PMC free article] [PubMed] [Google Scholar]
  15. Grey Neil, Maljanian Rose, Staff Ilene, Cruzmarino de Aponte Marisol. Improving care of diabetic patients through a collaborative care model. Conn Med. 2002 Jan;66(1):7–11. [PubMed] [Google Scholar]
  16. Haywood L. J. Hypertension in minority populations. Access to care. Am J Med. 1990 Mar 12;88(3B):17S–20S. doi: 10.1016/0002-9343(90)90005-x. [DOI] [PubMed] [Google Scholar]
  17. Hueston W. J., Hubbard E. T. Preventive services for rural and urban African American adults. Arch Fam Med. 2000 Mar;9(3):263–266. doi: 10.1001/archfami.9.3.263. [DOI] [PubMed] [Google Scholar]
  18. Lowenstein S. R., Koziol-McLain J., Thompson M., Bernstein E., Greenberg K., Gerson L. W., Buczynsky P., Blanda M. Behavioral risk factors in emergency department patients: a multisite survey. Acad Emerg Med. 1998 Aug;5(8):781–787. doi: 10.1111/j.1553-2712.1998.tb02504.x. [DOI] [PubMed] [Google Scholar]
  19. Mouton C. P., Beaudouin R., Troutman A., Johnson M. S. Barriers to follow-up of hypertensive patients. J Health Care Poor Underserved. 2001 Aug;12(3):290–301. doi: 10.1353/hpu.2010.0753. [DOI] [PubMed] [Google Scholar]
  20. Murray L. A. Racial and ethnic differences among Medicare beneficiaries. Health Care Financ Rev. 2000 Summer;21(4):117–127. [PubMed] [Google Scholar]
  21. Ockene J. K., Zapka J. G. Physician-based smoking intervention: a rededication to a five-step strategy to smoking research. Addict Behav. 1997 Nov-Dec;22(6):835–848. doi: 10.1016/s0306-4603(97)00065-8. [DOI] [PubMed] [Google Scholar]
  22. Qureshi M., Thacker H. L., Litaker D. G., Kippes C. Differences in breast cancer screening rates: an issue of ethnicity or socioeconomics? J Womens Health Gend Based Med. 2000 Nov;9(9):1025–1031. doi: 10.1089/15246090050200060. [DOI] [PubMed] [Google Scholar]
  23. Sacco R. L., Benjamin E. J., Broderick J. P., Dyken M., Easton J. D., Feinberg W. M., Goldstein L. B., Gorelick P. B., Howard G., Kittner S. J. American Heart Association Prevention Conference. IV. Prevention and Rehabilitation of Stroke. Risk factors. Stroke. 1997 Jul;28(7):1507–1517. doi: 10.1161/01.str.28.7.1507. [DOI] [PubMed] [Google Scholar]
  24. Simoes E. J., Newschaffer C. J., Hagdrup N., Ali-Abarghoui F., Tao X., Mack N., Brownson R. C. Predictors of compliance with recommended cervical cancer screening schedule: a population-based study. J Community Health. 1999 Apr;24(2):115–130. doi: 10.1023/a:1018754307718. [DOI] [PubMed] [Google Scholar]
  25. Sox C. M., Swartz K., Burstin H. R., Brennan T. A. Insurance or a regular physician: which is the most powerful predictor of health care? Am J Public Health. 1998 Mar;88(3):364–370. doi: 10.2105/ajph.88.3.364. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Steiner C. B. Access to cancer prevention, detection, and treatment. Cancer. 1991 Mar 15;67(6 Suppl):1736–1740. doi: 10.1002/cncr.2820671806. [DOI] [PubMed] [Google Scholar]
  27. Weinick R. M., Zuvekas S. H. Experience of primary care by racial and ethnic groups. Med Care. 2000 Apr;38(4):447–448. doi: 10.1097/00005650-200004000-00011. [DOI] [PubMed] [Google Scholar]

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