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Press Release Date: November 14, 2000
Three articles from the Agency for Healthcare Research and Quality (AHRQ) exploring different aspects of racial and ethnic disparities in health care are published in a special theme supplement of the November issue of Medical Care Research and Review. The articles discuss health insurance status, access to and use of health care services, and cultural competency.
Two of the articles provide trend data from AHRQ's medical expenditures surveys. The first, from Alan C. Monheit and Jessica Vistnes on health insurance status from 1987 through 1996, says that, among workers, Hispanic men and Hispanic and black women experienced the largest declines in employment-related coverage over the decade. Hispanic male workers were the only group for whom offers of insurance through their jobs actually declined; at the same time, their family incomes declined, making it harder for them to afford coverage when offered the choice. In addition, they were less likely in 1996 than in 1987 to be married or be a member of a union, reducing two important sources of health coverage.
The second article, on access to and use of health care services measured from 1977 through 1996, found that while improving income levels and health insurance coverage among racial and ethnic groups can improve their access to and use of health care services, it would not eliminate all disparities between Hispanic, black and white Americans. The researchers, Robin M. Weinick, Samuel H. Zuvekas, and Joel W. Cohen, caution that the reasons for the disparities are complex, but some possible factors include job-related and nonfinancial barriers to access, a lack
of cultural and linguistic competency among health care providers and institutions, and providers who are located in areas inconvenient to where various racial and ethnic groups live.
The third AHRQ article in this theme issue discusses cultural competency and whether it can reduce racial and ethnic health disparities. The authors, Cindy Brach and Irene Fraser, developed a conceptual model of the potential for cultural competency to reduce disparities, using the research literature both to develop the model and to analyze whether the evidence supported it. They conclude that while improving cultural competency should work, health systems are hampered by having little evidence about which techniques are effective and when and how to
implement them properly.
The three AHRQ articles in Medical Care Research and Review, Vol 57 Supplement 1, (November 2000) are "Race/Ethnicity and Health Insurance Status: 1987 and 1996," pp. 11-35, "Racial and Ethnic Differences in Access To and Use of Health Care Services, 1977 and 1996," pp. 36-54, and "Can Cultural Competency Reduce Racial and Ethnic Disparities? A Review and Conceptual Model," pp. 181-217.
The Agency's newly redesigned Web site now includes a special section for reporters. Select http://www.ahrq.gov/news/vnewsix.htm for easier access to the latest news and information about AHRQ's research and products.
For additional information please contact AHRQ Public Affairs, (301) 427-1364; Karen Carp, (301) 427-1858, KCarp@ahrq.gov; Karen Migdail, (301) 427-1855 , KMigdail@ahrq.gov.