Black adults consistently exhibit higher rates and poorer outcomes of cardiovascular disease (CVD) relative to other racial groups, even after accounting for differences in socioeconomic status (SES). Whether factors related to health care access can further explain racial disparities in CVD have not been thoroughly examined. Using logistic regression we examined racial and health care [i.e. health insurance and access to care] associations with CVD indicators [i.e. hypertension, low ankle-arm index, and left ventricular hypertrophy] in the Health, Aging, and Body Composition study, a longitudinal study of 3,075 well-functioning adults aged 70-79 in 1997. We found older Black versus White adults had significantly worse health care. Overall, health care only slightly reduced the significant association between being Black and CVD, while race remained strongly associated with CVD after adjusting for demographics, SES, body mass index, and comorbidity. Research on health care quality may contribute to our understanding of these disparities.
KeywordsUnited States of America; racial disparities; health insurance; access to care; socioeconomic status; cardiovascular disease Substantial racial disparities in health exist between older Black and White adults, often as a reflection of an earlier age at onset of chronic conditions, more rapid declines in health, and higher rates of co-morbid conditions, disease-related disability, and mortality in Black adultsPlease direct correspondence to Ronica N. Rooks, Department of Sociology, Kent State University, 329 Merrill Hall, Kent, OH 44242, rrooks@kent.edu. Ronica N. Rooks, is an assistant professor in the Department of Sociology at Kent State University. Her work focuses on racial and socioeconomic status health disparities among older African Americans.
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NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript (Bulatao and Anderson 2004;Ferraro and Farmer 1996; Martin and Soldo 1997). Access to quality health care is associated with better prevention, detection, and control of chronic disease processes and consequently improved physical functioning outcomes (Brown, Bindman, and Lurie 1998;Satish et al. 1997;Satish et al. 1998; Tan et al. 2003). Health care may be even more important in health outcomes of older adults, as they rely on these resources more frequently to cope with chronic disease than younger adults (Freeborn 1990;Gold 1996; Wolinsky, Mosely, and Coe 1986). Therefore, if quality health care can improve chronic disease risk and outcomes, then it may help explain racial disparities in health. et al. 2002). Although SES had little direct impact on reducing the racial association with the CVD indicators, we believe access to affordable health care, another dimension of SES, may further explain why racial disparities in heart disease continue to exist.Health insurance is believed to be associated with better health by improving the quality and quantity of access to health care (Brown et al. 1998). For older adults with ...