Healthcare inequality

Healthcare inequality (also called health disparities in some countries) refers to the disparities in the access to adequate healthcare between different gender, race, and socioeconomic groups. In the United States, women are more likely to have access to adequate medical care than men, ethnic minorities are less likely to have access to proper medical care than non-ethnic minorities, and within all groupings, individuals of higher socioeconomic standing are more likely to have access to adequate medical care than individuals of lower socioeconomic standing. [Merzel, C. (2000). Gender differences in health care access indicators in an urban, low-income community. American Journal of Public Health, 90(6), 909-916.]

Healthcare inequality in the United States is closely related to health inequality, in which significant disparities in overall level of health in individuals also exist between differing socioeconomic groups, with lower-status socioeconomic groups generally having poorer health and higher rates of chronic illness including, but not limited to obesity, diabetes, and hypertension. [Hurst, C. E. (2007). Chapter 10: The impact of inequality on personal life chances. Social inequality (6th ed., pp. 243-251). Boston: Pearson.] Lower-status socioeconomic groups also receive less consistent primary care, which is positively correlated to overall level of health in the recipient. [Merzel, C. (2000). Gender differences in health care access indicators in an urban, low-income community. American Journal of Public Health, 90(6), 910.]

Healthcare Inequality and Gender

The results in comparing inequities in access to adequate healthcare and gender are somewhat surprising, with women in the United States generally having higher levels of access to care. These disparities can be explained in part by looking at rates of overall insurance coverage (privatized and publicly assisted) between men and women, the effects of certain socioeconomic factors on levels of coverage between men and women, and overall gender-based differences in perceptions of health and health care.

In the United States, women have better access to healthcare, in part, because they have higher rates of health insurance. In one study of a population group in Harlem, 86% of women reported having health insurance (privatized or publicly assisted), while only 74% of men reported having any health insurance. This trend in women reporting higher rates of insurance coverage is not unique to this population and is representative of the general population of the US. [Merzel, C. (2000). Gender differences in health care access indicators in an urban, low-income community. American Journal of Public Health, 90(6), 911.]

Gender based perceptions of health and healthcare may help explain some of the lag of men behind women in levels of insurance coverage. Women report higher rates of illness than men, which barring the idea that women are sicker than men, indicates women are more likely to seek medical care out and are therefore more likely to possess medical insurance. [Merzel, C. (2000). Gender differences in health care access indicators in an urban, low-income community. American Journal of Public Health, 90(6), 910.]

Gender related disparities in access to healthcare are also related to socioeconomic factors including geographic job-market differences and differing levels of government assistance available to men and women. There are fewer job opportunities with insurance coverage available to men and women living in poorer communities, and of these opportunities, women tend to occupy more of the jobs with these benefits. Government assistance available to these individuals without job-related coverage varies between men and women, with women, especially women with children, receiving a higher percentage of available public assistance than men. [Merzel, C. (2000). Gender differences in health care access indicators in an urban, low-income community. American Journal of Public Health, 90(6), 909.] Ultimately, for both men and women discrepancies in access to adequate healthcare is largely based on socioeconomic issues including income and full-time work status, with both groups of men and women with higher levels of income and full-time work receiving greater access to adequate healthcare. [Merzel, C. (2000). Gender differences in health care access indicators in an urban, low-income community. American Journal of Public Health, 90(6), 911.]

Healthcare Inequality and Race

The United States historically had large disparities in health and access to adequate healthcare between races, and current evidence supports the notion that these racially-centered disparities continue to exist and are a significant social health issue. [Weinick, R. M., Zuvekas, S. H., & Cohen, J. W. (2000). Racial and ethnic differences in access to and use of health care services, 1977 to 1996. Medical care research and review : MCRR, 57 Suppl 1, 36-54.] The disparities in access to adequate healthcare include differences in the quality of care based on race and overall insurance coverage based on race.

The Journal of the American Medical Association identifies race as a significant determinant in the level of quality of care, with ethnic minority groups receiving less intensive and lower quality care. Ethnic minorities receive less preventative care, are seen less by specialists, and have fewer expensive and technical procedures than non-ethnic minorities. [Fiscella, K., Franks, P., Gold, M. R., & Clancy, C. M. (2000). Inequality in quality: Addressing socioeconomic, racial, and ethnic disparities in health care. JAMA: The Journal of the American Medical Association, 283(19), 2579-2584.]

There are also considerable racial disparities in access to insurance coverage, with ethnic minorities generally having less insurance coverage than non-ethnic minorities. For example, Hispanic Americans tend to have less insurance coverage than white Americans and receive less regular medical care. The level of insurance coverage is directly correlated with the level of access to healthcare including preventative and ambulatory care.

Ultimately, healthcare inequality in the United States is certainly an issue of race, as considerable disparities in levels of access to healthcare exist between ethnic minorities and whites, with ethnic minorities continuing to rank significantly lower than whites in levels of access to adequate healthcare. [Weinick, R. M., Zuvekas, S. H., & Cohen, J. W. (2000). Racial and ethnic differences in access to and use of health care services, 1977 to 1996. Medical care research and review : MCRR, 57 Suppl 1, 36-54.]

Healthcare Inequality and Socioeconomic Status

While gender and race play significant factors in explaining healthcare inequality in the United States, socioeconomic status is the greatest determining factor in an individuals level of access to healthcare. Not surprisingly, individuals of lower socioeconomic status in the United States have lower levels of overall health, insurance coverage, and less access to adequate healthcare. Furthermore, individuals of lower socioeconomic status have less education and often perform jobs without significant health and benefits plans, whereas individuals of higher standing performs jobs that are more likely to have jobs that provide medical insurance. [Merzel, C. (2000). Gender differences in health care access indicators in an urban, low-income community. American Journal of Public Health, 90(6), 911.]

References

ee also

*Health disparities
*Center for Minority Health