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APHA Scientific Session and Event Listing

Recorded presentation

Fernando A. Wagner, ScD¹, Shijun Zhu, PhD², Patricia Clubb, PhD², and Dorothy Browne, MSW, MPH, DrPH³. (1) Prevention Sciences Research Center and the Center for Health Disparities Solutions, Morgan State University School of Public Health and Policy, 1700 East Cold Spring Lane, Montebello D103, Baltimore, MD 21251, 443.885.4518, fwagner@jewel.morgan.edu, (2) Prevention Sciences Research Center and the Center for Health Disparities Solutions, Morgan State University, School of Public Health and Policy, 1700 East Cold Spring Lane, Jenkin 343, Baltimore, MD 21251, (3) Prevention Sciences Research Center and Center for Health Disparities, Morgan State University School of Public Health and Policy, 1700 East Coldspring Lane, Montebello D325, Baltimore, MD 21251

We sought to disentangle health disparities among people with nicotine and alcohol involvement, in terms of health care utilization, by comparing the experience of men and women from two adjacent census tracts that differed by race but had similar sociodemographic characteristics. This epidemiologic strategy allows studying possible disparities with a sharpened focus because many potential confounders are held constant. Methods. The Community Health Urban Project (CHUP) was a cross-sectional survey carried out with a sample of adults ages 18 and above, living in two adjacent census tracts in a mid-size metropolitan area in the mid-Atlantic region. Health care utilization was measured via asking for the number of visits to a doctor in the past two years. Measures of tobacco, alcohol, and depression were derived from large-scale epidemiologic surveys. The analyses are based on data from 1425 adults with complete information (95% of all participants). GEE negative binomial models were used. Results. People with depression and who smoke had fewer visits to the doctor than those with depression who did not smoke (IRR=1.6 vs 2.3) after controlling for gender, age, education, working status, and access to health care. Comment. The reduced health care utilization may be due to stigma. as furthter preliminanary analyses suggest.

Learning Objectives: At the conclusion of the session, the participant(learner) in this session will able to

• Understand differences by race/ethnicity in tobacco, alcohol, depression and their relation to health care utilization;
• Identify the role of stigma and other psychosocial processes that may influence health care utilization in conjunction with socioeconomic and access variables; and
• Discuss implications of these findings for public health.

Keywords: African American, Health Care

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation