Ethnic minorities and access to medical care: where do they stand?

Recent research on access to medical care suggests that although minorities may have achieved equity of access during the 1980s, this may no longer be the case. Data collected in the National Medical Expenditure Survey for 1987 are used to examine how African Americans, Asian Americans, and Hispanic Americans fare relative to white Americans on measures of access. Questions on insurance, income, race/ethnicity, place of residence, usual source of care, and use of ambulatory services were asked in a national probability sample of 36,400 US residents. This study found that while only 4.4% of the US population regularly used an outpatient department or emergency room in 1987, 9.9% (P < .0001) of Hispanic Americans, 15.8% (P < .0001) of African Americans regularly used a hospital-based site for their medical needs. Whereas 14% of all Americans were uninsured, 21% (P < .0001) of African Americans and 32% (P < .0001) of Hispanic Americans were uninsured. While 70.6% of all Americans made at least one ambulatory visit to a physician during 1987, 63% (P < .0001) of African Americans, 59% (P < .0001) of Hispanic Americans, and 54.6% (P < .0001) of Asian Americans saw a physician in 1987. Controlling for health status, disparities remained in the use of services for uninsured Americans regardless of race/ethnicity.