Access to Health-Care and Preventive Services Among Hispanics and Non-Hispanics — United States, 2001–2002

ISEE-13 Introduction: Although Hispanics are the largest ethnic minority population in the United States, they are underserved by the health-care system. Aim: The objective of this study is to examine differences in access to health-care and preventive services between Hispanics and non-Hispanics. Methods: We analyzed data for 2001–2002 using the Behavioural Risk Factor Surveillance System (BRFSS). BRFSS is a state-based, random-digit–dialed telephone survey of the U.S. civilian, non-institutionalized population aged ≥ 18 years and is conducted in all 50 states and the District of Columbia. The BRFSS data files were edited and aggregated to create a yearly sample for each state. Each sample was weighted to the respondent’s probability of selection and to age- and sex-specific or race-age and sex-specific population from the most current census data. To compare Hispanics and non-Hispanics, prevalence estimates were adjusted to the 2000 U.S. standard population. All results were statistically significant at (p<0.01 or p<0.05). Analyses were adjusted for respondents’ sex, marital status, employment status, and self-rated general health status. Results: In 2002, a total of 247,964 interviews were completed; 18,152 were by Hispanic and 229,812 by non-Hispanic respondents. In 2001, a total of 212,510 interviews were completed; 17,588 were by Hispanic and 194,922 by non-Hispanic respondents. Hispanic respondents were significantly more likely than non-Hispanic respondents to be aged 18–44 years; have less than a high school education; be unemployed, unable to work, or a homemaker or student; reside in the Western region of the country; and report fair or poor general health. Hispanic respondents were significantly less likely than non-Hispanic respondents to have health-care coverage (76.2% versus 90.6%), have one or more regular personal health-care providers (68.5% versus 84.1%), or have a regular place of care (93.4% versus 96.2%). Hispanics also were significantly less likely to be screened for breast, cervical, and colorectal cancers, blood cholesterol levels, to receive a pneumococcal vaccination and to receive an influenza vaccination within the previous year. Discussion: Disparities in access to health-care and screening practices between Hispanics and non-Hispanics persist. Strategies to reduce barriers to health-care and screening practices must be implemented among Hispanics. These strategies might include using culturally appropriate programs, adapting intervention programs proven to be effective with other populations, and targeting specific barriers to care such as poverty and health-care professionals’ lack of knowledge about how best to encourage Hispanics to use those preventive services that are available.