214282 Consequences of impaired health care utilization exacerbated by an uninsured/underinsured condition among minority populations practicing risky sexual behaviors

Tuesday, November 9, 2010 : 1:00 PM - 1:15 PM

Mandy J. Roberts, DrPH, MPH , Emergency Medicine, University of Texas, Medical School, Houston, TX
Michael W. Ross, PhD , WHO Center for Health Promotion Research and Development, The University of Texas - Houston School of Public Health, Houston, TX
Ronald J. Peters, DrPH , School of Public Health/Center for Health Promotion & Prevention Research, University of Texas at Houston, Houston, TX
Christine Markham, PhD , Center for Health Promotion and Prevention Research, University of Texas Health Science Center-Houston, Houston, TX
Objective: 1. To identify behavioral determinants associated with ‘sexual risk' among a majority African American (AA) population in Houston, TX; 2. To determine the magnitude of effect the social injustice caused by an uninsured/underinsured condition has on exacerbating poor health outcomes of an at-risk patient population.

Methods: Questionnaires administered to 215 Houston residents. Bivariate analysis revealed p<.15 for income and ‘sexual risk' variables related to usual source of health care. Homelessness, depression, income, and ‘sexual risk' variables were associated with delayed medical care. Gender stratified variables were analyzed by an overall odds ratio (OR), 95% CI, and p-value calculation. Variances in health care utilization relative to each determinant were noted. Logistic regression models calculated adjusted odds ratios.

Results: Women having had STIs and depression were likely to delay care. Men testing negative for HIV, a history of homelessness, low income, and public assistance delayed medical care. Conclusion: Assessment of a usual source of care and/or delayed medical care revealed a relationship between historical inequities fueling social injustices and existing minority related, sexual health disparities. Future interventions should target populations with histories of STIs, depression, low income, and homelessness when the desired outcome is health care seeking behavior change.

Learning Areas:
Clinical medicine applied in public health
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. To describe behavioral, situational, and environmental determinants contributing to to risky sexual behaviors resulting in outcomes such as HIV/AIDS and STIs, particularly gonorrhea. 2. To discuss the effect social injustice has on a vulnerable population subject to an uninsured/underinsured condition.

Keywords: African American, Risky Behaviors

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I direct the public health foci in emergency medicine, focusing on disease prevention, particularly prevention of HIV and STIs.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.