Recorded presentation

Leiyu Shi, DrPH, MBA, Department of Health Policy and Management, Johns Hopkins University School of Hygiene and Public Health, 624 N. Broadway, Room 409, Baltimore, MD 21212 and Gregory D. Stevens, PhD, Pediatrics, UCLA Center for Healthier Children, Families, and Communities, 1100 Glendon Ave, Suite 850, Los Angeles, CA 90024, 310-794-2638, gregorydstevens@yahoo.com.

Context: Previous studies have demonstrated a strong association of minority race/ethnicity, low socioeconomic status (SES), and lacking a regular source of care with poor receipt of preventive services. Most studies examine independent effects of these factors, but more pragmatic models of vulnerability are needed to account for the concomitant influence of multiple risk factors. Objective: To operationalize a profile of vulnerability composed of multiple risk factors reflecting key predisposing (i.e. income and education) and enabling domains (i.e. health insurance and regular source of care) of access, and present its association with receipt of preventive services. Study Design: Cross-sectional data on 15,604 adults from the Household Component of the 1996 Medical Expenditure Panel Survey (MEPS). Main Outcome Measures: Self-reported receipt of set of recommended services including blood pressure screening, cholesterol check, flu shot, pap smear, mammogram, and a dental visit. Results: Controlling for individual demographics and managed are enrollment, adults with low income, with less than a high school education, lacking insurance or a regular source of health care were less likely to receive most preventive services. In contrast to other studies, minorities were equally or more likely than whites to receive cholesterol screenings, pap smears, and mammograms. The risk factors in the vulnerability profile were additively related with the receipt of preventive services. For example, compared to no risks, individuals with one risk factor had 0.56 the odds (CI: 0.46, 0.62) of receiving a cholesterol screening; those with two risks had 0.26 the odds (CI: 0.20, 0.33), and those with three or more had 0.12 the odds (0.08, 0.17). The pattern held for each racial/ethnic group. Conclusion: Vulnerability factors contribute independently and also have substantial additive association with the receipt of recommended preventive services. Without attention to the profile of risk factors adults have, it is unlikely that substantial gains will be made in reducing the incidence, severity, and mortality associated with the most common preventable diseases among US adults.

Learning Objectives:

• Audience will be able to identify how many adults are considered at-risk for poor receipt of preventive care according to a profile of risk-factors.
• Audience will be able to describe how these risk factors contribute and combine to influence disparities in receipt of preventive care.
• Audience will learn potential strategies to solving disparities in the receipt of preventive services that take account of the profile of risk factors that adults have.

Keywords: Health Care Access, Preventive Medicine

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.

Recorded presentation