Disparities in barriers to health care access among people with disabilities from underserved racial and ethnic groups: Results from a scoping review

Background: Understanding barriers to health care access experienced by people with disabilities who are also members of underserved racial and ethnic groups is key to developing successful interventions to improve access. The present study systematically examined the peer-reviewed literature regarding barriers to health care access for people with disabilities from underserved racial or ethnic groups. Methods: Disability was framed with a functional definition inclusive of physical, sensory, cognitive, social, or activity limitations. Barriers were defined broadly and included any factor other than race, ethnicity, or disability in relation to any type of health care access. Using systematic scoping review methodology, electronic searches, table of contents reviews of key journals, and reviews of reference lists of included articles were performed to collect literature published during the years 2000 – 2009.

Results: Searches yielded 3023 unique abstracts. Ten articles met all inclusion criteria. Data extraction, performed independently by two reviewers, revealed that several disability types were represented in published research, but the only underserved racial or ethnic groups represented (in combination with disability) were African Americans and Latinos. The most frequently described barriers to health care were: uninsurance, insurance type, language, low education level, patient feelings, and no usual source of care. A narrative synthesis was conducted to examine whether each observed barrier was primarily related to race, culture, language, disability, socioeconomics, or other phenomena. Conclusions: This synthesis offers an in-depth look at the understudied topic of health care access experiences of people at the intersection of disability, race, and ethnicity.