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Chronic Disease

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Lack of accessibility and affordability are linked to underdiagnosis of chronic disease in blacks and Hispanics

A new study links lack of accessibility, affordability, and continuity of medical care to underdiagnosis of chronic medical conditions among blacks and Hispanics. The researchers correlated self-diagnosis of chronic medical and mental health conditions among 287 black and Latino heads of households in 3 urban public housing communities in Los Angeles County with a physician's diagnosis of the conditions.

Overall, 85 percent of those interviewed said that they were suffering from at least one chronic condition. However, 43 percent of them claimed that a physician had never diagnosed at least one of their illnesses. For example, only one in three individuals who said they suffered from depression were ever diagnosed with depression by a physician. Only half of those self-diagnosed with hearing impairment were diagnosed by a physician, and only about one in five who said they suffered from arthritis, dental problems, or blood circulation problems were diagnosed by a physician. Physician-based diagnosis of medical conditions was associated with five enabling factors: greater accessibility to medical services, affordability of medical care, availability of health-related information, continuity of medical care, and less financial strain. Need-for-care characteristics were not significant.

The findings suggest that for patients with a similar health condition, those with better access to medical care are more likely to be diagnosed by physicians.

The study was supported in part by the Agency for Healthcare Research and Quality (HS14022). More details are in "Correlates of self-diagnosis of chronic medical and mental health conditions in under-served African American and Latino populations," by Chizobam Ani, M.D., M.P.H., Mohsen Bazargan, Ph.D., Shahrzad Bazargan-Hejazi, Ph.D., and others in the Spring 2008 Ethnicity & Disease 18(2 Suppl. 2), pp. S2-105-S2-111.

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