Racial/Ethnic and Gender Disparities in Health Care Use and Access

Jennifer I. Manuel

Research output: Contribution to journalArticlepeer-review


Objective: To document racial/ethnic and gender differences in health service use and access after the Affordable Care Act went into effect. Data Source: Secondary data from the 2006–2014 National Health Interview Survey. Study Design: Linear probability models were used to estimate changes in health service use and access (i.e., unmet medical need) in two separate analyses using data from 2006 to 2014 and 2012 to 2014. Data Extraction: Adult respondents aged 18 years and older (N = 257,560). Principal Findings: Results from the 2006–2014 and 2012–2014 analyses show differential patterns in health service use and access by race/ethnicity and gender. Non-Hispanic whites had the greatest gains in health service use and access across both analyses. While there was significant progress among Hispanic respondents from 2012 to 2014, no significant changes were found pre–post-health care reform, suggesting access may have worsened before improving for this group. Asian men had the largest increase in office visits between 2006 and 2014, and although not statistically significant, the increase continued 2012–2014. Black women and men fared the worst with respect to changes in health care access. Conclusions: Ongoing research is needed to track patterns of health service use and access, especially among vulnerable racial/ethnic and gender groups, to determine whether existing efforts under health care reform reduce long-standing disparities.

Original languageEnglish (US)
Pages (from-to)1407-1429
Number of pages23
JournalHealth Services Research
Issue number3
StatePublished - Jun 2018


  • Utilization/access of services
  • disparities
  • gender
  • race/ethnicity

ASJC Scopus subject areas

  • Health Policy


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