Access to primary care: Disparities among minority children in Wisconsin

Persistent inequalities in children's access to primary care have been frequently observed among minority populations. To some extent, unequal access can be attributed to socioeconomic variations existing across ethnic minorities. Nevertheless, race/ethnicity itself reflects cultural, language, and historical differences, and contributes in a unique way to overall health disparities. This study sought to measure racial/ethnic disparities in primary care access among Wisconsin children, as well as those uninsured but eligible for public health insurance coverage. Our data included 12,212 children (aged 0-18) from the 2000-2005 Wisconsin Family Health Survey, a statewide random sample telephone survey for collecting information regarding insurance coverage and use of health care services. Multivariate log-linear analyses were used to estimate risks of access barriers after adjusting for poverty and socio-demographic factors. Results revealed that Hispanic, black, and American Indian children were less likely to be insured (RRs=1.7-2.3, p<.05) and less likely to have a usual source of primary care (RRs=1.1-1.9, p<.05), compared with non-minority children. Interestingly, these children showed higher usage in annual physical checkups (RRs=0.4-0.8, p<.05). Although Asian children were mostly insured, their use of primary care services was substantially lower than any other racial/ethnic group. Noteworthy, despite the fact that more than 65% of uninsured minority children were eligible for public health insurance programs, they (except the American Indian) were less likely to enroll (RRs=1.22-1.45 p<.05). Specific policies, therefore, are needed to reduce racial/ethnic gaps in children's primary care access, and to improve enrollment rates among uninsured minority children eligible for public insurance programs.