Use of medical care for chest pain: differences between blacks and whites.

Strogatz, David

doi:10.2105/ajph.80.3.290

Cited by 61 publications

(16 citation statements)

References 35 publications

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“…15 Another explanation is that minorities may not perceive the value of obtaining early and preventive health care, thus diminishing their use of outpatient services. [42][43][44] However, as above, minorities with equal access to primary care receive equal or greater preventive services, and multiple programs directed at increasing specific preventive care interventions have succeeded in diminishing or eliminating the gap between minorities and nonminorities, particularly in the areas of breast and cervical cancer screening. 45,46 Despite lower receipt of care in the outpatient setting, it does not appear that minorities turn to emergency rooms for care disproportionately.…”

Section: Discussionmentioning

confidence: 99%

Variation in participation in health care settings associated with race and ethnicity

Bliss¹,

Meyers

Phillips

et al. 2004

J GEN INTERN MED

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OBJECTIVE:To use the ecology model of health care to contrast participation of black, non-Hispanics (blacks); white, non-Hispanics (whites); and Hispanics of any race (Hispanics) in 5 health care settings and determine whether disparities between those individuals exist among places where they receive care. DESIGN:1996 Medical Expenditure Panel Survey data were used to estimate the number of black, white, and Hispanic people per 1,000 receiving health care in each setting. SETTING:Physicians' offices, outpatient clinics, hospital emergency departments, hospitals, and people's homes. MAIN MEASUREMENT:Number of people per 1,000 per month who had at least one contact in a health care setting. RESULTS: According to a recent report by the Centers for Disease Control (CDC), racial and ethnic minorities fare worse than nonminorities in several major health status categories, with little progress in reduction of disparities in most areas since 1990.1 For blacks and Hispanics, the incidence of infant and maternal mortality is higher, life expectancy is lower, and rates of some chronic diseases are greater than for whites. The overwhelming evidence of disparities in health and health care has sparked research comparing populations in terms of their characteristics or receipt of specific services. However, this perspective does not address the broader interactions of populations with the various settings of health care. Looking at populations and where they go when they decide to seek health care provides an "outside-in" view that helps explain where there is the greatest contribution to disparities.The Ecology of Medical Care by White et al. in 1961 19 and reprised by Green et al. in 2001 20 is an example of such a perspective. The ecology model depicts the number of people per 1,000 who access the health care system in an average month. The model does not report the quantity of services provided, focusing instead on individuals and whether they received any care in a health care setting. The methods of the ecology model do not permit conclusions about cause and effect, but they do elucidate who is getting care in those settings.

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Section: Discussionmentioning

confidence: 99%

Variation in participation in health care settings associated with race and ethnicity

Bliss¹,

Meyers

Phillips

et al. 2004

J GEN INTERN MED

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“…Symptom perception may thus influence the differential use of health care services for CHD [52,53] and other illnesses. Previous research has shown that African Americans perceive their symptoms to be less severe [54], and believe that they have less access to health care [43] and that the health care system is less responsive to them once they do seek care [42]; thus, they may be less likely to see medical intervention as necessary or obtainable.…”

Section: Brief Background Of the Usphs-tuskegee Syphilis Study And Rementioning

confidence: 99%

The Tuskegee Legacy Project: history, preliminary scientific findings, and unanticipated societal benefits

Katz

Kegeles

Green

et al. 2003

Dental Clinics of North America

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SummaryThis article is intended to provide a relatively complete picture of how a pilot study-conceived and initiated within an NIDCR-funded RRCMOH-matured into a solid line of investigation within that center and "with legs"into a fully funded study within the next generation of NIDCR centers on this topic of health disparities, the Centers for Research to Reduce Oral Health Disparities. It highlights the natural opportunity that these centers provide for multicenter, cross-disciplinary research and for research career pipelining for college and dental school students; with a focus, in this case, on minority students.Furthermore, this series of events demonstrates the rich potential that these types of research centers have to contribute in ways that far exceed the scientific outcomes that form their core. In this instance, the NMOHRC played a central-and critical, if unanticipated-role in contributing to two events of national significance, namely the presidential apology to the African American community for the research abuses of the USPHS-Tuskegee syphilis study and the establishment of the National Center for Bioethics in Research and Health Care at Tuskegee University. Origins of the Tuskegee Legacy ProjectThe Tuskegee Legacy Project (TLP) has its origins in casual Web surfing by a biomedical reference librarian on her laptop computer on a fall evening in 1993 while relaxing in the dormer room, which served as the family den. Ms. B.J. Frey, Head Reference Librarian at the * Corresponding author. E-mail address: ralph.katz@nyu.edu (R.V. Katz).This research project was supported by NIDCR/NIH grant #P50 DE10592 (University of Medicine and Dentistry of New Jersey/ University of Connecticut Northeastern Minority Oral Health Research Center), and is currently supported in the analysis phase by NIDCR/NIH grant #U54 DE 14257 (NYU Oral Cancer RAAHP Center).Research Centers supported by the NIH are fully intended to create a vortex of scientific activity that goes well beyond the direct scientific aims of the studies initially funded within those centers. The maxim is that the whole should be greater than the sum of its initial constituent studies or parts. We believe that NMOHRC did indeed achieve that maxim-even extending "the whole" to include broad societal impact, well beyond the scope of important, but mere, scientific outcomes-all within the concept and appropriate functions of a scientific NIHfunded research center. NIH Public Access

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“…However, we found that this ratio was slightly less for Aboriginal parents than for non-Aborigines. It was thought that differences in the parents' perception of how serious the child's illness was may result in a difference in utilization of medical services, 7 and cultural differences between Aboriginal and non-Aboriginal OR, odds ratio; AOR, adjusted odds ratio: **P Ͻ 0.01; *P Ͻ 0.05; # 0.05 Ͻ P Ͻ 0.1.…”

Section: Discussionmentioning

confidence: 99%

“…7,17 We believe that alternative treatments such as traditional folk medicines were substituted for western medicines only if the latter were difficult to access. Decades ago, the Taiwanese Aborigines used traditional folk medicine, such as herbal and shamanistic methods for treatment of their diseases.…”

Section: Discussionmentioning

confidence: 99%

“…3 Current investigations indicate that life expectancy for Aborigines is on average 10 years less than that of the general population, with a standardized mortality ratio approaching 2-fold. 7 Accidental injuries, suicide, tuberculosis, liver cirrhosis, alcoholism, pneumonia, bronchitis and parasitic infections are the most important sources of disease. Hypertension, heart disease, gout, cancer of some sites and nutrition are gradually becoming important new sources of disorders.…”

Section: Introductionmentioning

confidence: 99%

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Differences in physician utilization between Aboriginal and non-Aboriginal children

Tsu-Nai²,

Hsieh³

et al. 2000

Family Practice

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Objective. In the present study, we examined the factors affecting Aboriginal children's visits to a medical practitioner and compared them with non-Aboriginal children.Methods. We selected five Aboriginal communities and four neighbouring non-Aboriginal communities, and conducted a door-to-door survey, covering all children born after 1983. Of an initial sample of 1013 children, 896 (response rate 89.92% for non-Aboriginal children and 85.87% for Aboriginal children) completed the questionnaire for analysis.Results. In all, 896 children of non-mixed lineage with an age range of 0-12 years were collected into the study, including 316 Aborigines and 580 non-Aborigines. A higher percentage of non-Aboriginal children had more national health insurance coverage than Aboriginal children. The ratio of parents using the services of an out of community medical practitioner when their children were sick was higher for Aboriginal parents than for non-Aborigines. Medical injection frequency was higher in Aboriginal children. Linear regression was used to examine the factors affecting the frequency of physician utilization in the preceding month. Conclusion.A lower national health insurance coverage rate, and a higher rate of intramuscular injections for Aboriginal children plus difficulties in access to medical resources due to travel time and travel distance are still major problems for the Aborigines.

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Use of medical care for chest pain: differences between blacks and whites.

Cited by 61 publications

References 35 publications

Variation in participation in health care settings associated with race and ethnicity

Variation in participation in health care settings associated with race and ethnicity

The Tuskegee Legacy Project: history, preliminary scientific findings, and unanticipated societal benefits

Differences in physician utilization between Aboriginal and non-Aboriginal children

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