 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Susan X Lin, School of Nursing, Columbia University, 630 West 168th Street, New York, NY 10032, 212-305-6929, XL18@columbia.edu
PURPOSE: Research has consistently documented racial and ethnic disparity in healthcare. However, studies that focus on provision of health counseling to patients of different races in ambulatory care settings are sparse. Using a large national sample survey, the study examined the relationship between patient race and provision of health counseling in primary care practice settings. METHODS: Secondary data analysis of the National Ambulatory Medical Care Survey from 1997 through 2000. Patient visits to family and general practice, internal medicine, pediatrics and OB/GYN were included in the analyses. Rates of health counseling provided to White patients and Black patients at their visits to health care providers were estimated. Chi-square tests were performed and Logistic analyses were performed using SAS and SUDAAN by controlling for patient characteristics variables, practice setting variables, payment type, HMO status, the provider as patient's PCP and major reason for visit. RESULTS: In bi-variate analysis, Black patients received less health counseling and education on mental health and stress management than White patients, and Black female patients at age 40 or older received less education on breast self-exam than White females of the same age range. The results from the bivariate analysis also revealed that Black patients received more counseling on diet and HIV/STD than White patients. No differences were found between White patients and Black patients in terms of prenatal instruction for pregnant women, counseling on tobacco use, child growth and development, exercise and injury prevention. In the multivariate analysis, differences in counseling on breast self-exam and stress management to patients of two different races were no longer significant. But it was still found that Black patients were more likely than White patients to receive counseling on diet (OR=1.2 with 95 % CI from 1 to 1.4) and on HIV/SDT (OR=2.3 with 95% CI from 1.7 to 3.2). In addition, Black patients were less likely than White patients to receive counseling on mental health (OR=0.5 with 95% CI from 0.4 to 0.8). CONCLUSION: Of all types of health counseling examined, Black patients were more likely to receive counseling on diet and HIV/SDT prevention but less likely to receive counseling on mental health than White patients. No differences were found between Black patients and White patients in other types of health counseling. Further studies should be conducted to examine whether the differences can be explained by other patient and provider factors.
Learning Objectives:
Keywords: Prevention, Ethnicity
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.