Roberts R E, Lee E S
Med Care. 1980 Mar;18(3):267-81.
Data are presented from sample surveys conducted in 1974 (N = 3,119) and 1975 (N = 657) in Alameda County, California, by the Human Population Laboratory. Mexican-Americans are compared to Anglos and blacks in terms of physician visits, dental examinations, general physical examinations, and eye examinations. Comparison of crude percentages indicates that there is very little ethnic variation in either sample regarding regular source of medical care or health insurance coverage, although the trend is for fewer Chicanos to have such coverage. In terms of physician visits, there is little difference between Anglos and Chicanos. By contrast, fewer Chicanos and blacks report dental examinations in the past year (Chicanos have the lowest rate). Fewer Chicanos report a general medical examination in the past year and more report never having had a medical checkup. Likewise, more Chicanos report never having an eye examination while relatively fewer report such an exam in the past year. Controlling for the effects of age, sex, education, family income, health insurance, regular source of care, physical health status and perceived health reduces differences in rate of physician visits among the ethnic groups, primarily by reducing the rate for blacks and increasing the rate for Chicanos. Likewise, adjustment for all 8 factors reduces ethnic differences in general medical examination rates, in this case by increasing the rates for the minority groups. Adjustment reduces the ethnic differences in dental examination rates by increasing the minority group rates, but large differences still remain. For eye examinations, adjustment has little effect on the rates for Anglos and blacks, but substantially increases the rate for Chicanos. For all 4 types of medical care behavior, controlling for the effects of education and family income (so-called inequitable reasons for lower access to care) consistently produces the greatest effect, particularly for Chicanos. In each case, the effect is to create greater parity between Chicanos and Anglos by increasing the utilization rate for Chicanos. However, even after adjustment, the rate for Chicanos remains lower.
数据来自于1974年（样本量N = 3119）和1975年（样本量N = 657）加利福尼亚州阿拉米达县人类人口实验室进行的抽样调查。将墨西哥裔美国人与盎格鲁人及黑人在看医生、牙科检查、全身检查和眼科检查方面进行了比较。粗略百分比的比较表明，在定期医疗服务来源或医疗保险覆盖方面，两个样本中的种族差异都很小，尽管趋势是墨西哥裔美国人拥有此类保险的人数较少。在看医生方面，盎格鲁人和墨西哥裔美国人之间差异不大。相比之下，较少的墨西哥裔美国人和黑人报告在过去一年进行过牙科检查（墨西哥裔美国人的比例最低）。较少的墨西哥裔美国人报告在过去一年进行过全身检查，更多的人报告从未进行过体检。同样，更多的墨西哥裔美国人报告从未进行过眼科检查，而相对较少的人报告在过去一年进行过此类检查。控制年龄、性别、教育程度、家庭收入、医疗保险、常规医疗服务来源、身体健康状况和自我感知健康的影响后，各族裔在看医生率上的差异有所减小，主要是通过降低黑人的比率并提高墨西哥裔美国人的比率。同样，对所有8个因素进行调整后，全身检查率的种族差异也有所减小，在这种情况下是通过提高少数群体的比率。调整通过提高少数群体的比率减小了牙科检查率的种族差异，但仍存在较大差异。对于眼科检查，调整对盎格鲁人和黑人的比率影响不大，但大幅提高了墨西哥裔美国人的比率。对于所有4种医疗行为类型，控制教育程度和家庭收入的影响（即所谓获得医疗服务机会较低的不公平原因）始终产生最大的影响，尤其是对墨西哥裔美国人。在每种情况下，其效果都是通过提高墨西哥裔美国人的利用率，使墨西哥裔美国人和盎格鲁人之间的差距缩小。然而，即使经过调整，墨西哥裔美国人的比率仍然较低。
