Seeking help in illness and in health: Differences between African and white-Americans in health service use

Yan Yu, Purdue University

Abstract

This study examines the effect of social factors on medical care service use of African and white adults. The research question stems from an intriguing set of finding from health services research: African Americans have more health problems and are more frequently hospitalized, yet they visit physicians less often. By applying two theoretical frameworks in sociology, this study compares African and white Americans to gain a better conceptualization of ethnicity as a variable in studying health and medical care services use. The data are two-wave (1986 and 1989) longitudinal data from Americans' Changing Lives, with 3497 African and white subjects. The analytical strategies include t-tests and logistic and multiple regression. Besides separate sample analyses, significant differences between the magnitudes of the regression coefficients in different samples were tested by creating interaction terms between race and independent factors. Effects of independent factors at baseline on three dependent factors (self-rated health, physician visits, and hospitalization) are assessed. Separate sample analyses show that self-rated health is a significant predictor of physician visits for white Americans while chronic conditions and functional health are significant predictors for African Americans. Health insurance does not predict physician visits for the African American sample while it does predict use in the white sample. African Americans with more chronic conditions and with worse functional health are more likely to have visited a physician. African Americans who drink more and who visited physicians more often at the baseline have reported more physician visits at the follow-up. Also, African Americans who seek religious comfort are more likely to have been hospitalized for a longer period of time. African Americans who get transportation help at baseline are more likely to have been hospitalized and for longer periods of time. Longitudinal data with two or more waves are necessary in order to assess and compare rates of change in health and use of service. Also, it is desirable to measure social support derived from religious involvement in order to achieve a better understanding in social support and religious involvement.

Degree

Ph.D.

Advisors

Ferraro, Purdue University.

Subject Area

Welfare|Demographics|Minority & ethnic groups|Sociology|Public health

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