Disparity in access to a usual source of medical care among adults with disabilities in the United States

Background and Purpose: A growing body of research shows that persons with disabilities experience disparities in healthcare access compared to people without disabilities. However, there has been a dearth of research investigating disparities among people with disabilities. To help fill that gap, this study examined racial and ethnic disparities in having a usual source of care (USC) among working-age adults (18-64) with disabilities.

Methods: Using 2002-2008 data from the Medical Expenditure Panel Survey (MEPS) Household Component, we conducted logistic regression analyses to examine associations of USC with race/ethnicity after controlling for demographic factors (sex, age, marital status, education, region) and economic factors (insurance, employment, family income). All analyses accounted for the complex survey design of MEPS.

Results: Compared to non-Hispanic whites with disabilities, adults of color with disabilities were less likely to have a USC without adjusting for any factors (unadjusted odds ratio [OR] = 0.79, 95% CI = 0.71-0.89 for Blacks; 0.50, 95% CI = 0.45-0.55 for Hispanics; OR=0.69, 95% CI = 0.54-0.88 for Asian/Native Hawaiian/Pacific Islanders [AHPI]). After controlling for demographic and economic factors, disparities remained for Hispanics (adjusted odds ratio [AOR] = 0.71, 95% CI = 0.62-0.80) and AHPI (AOR= 0.65, 95% CI = 0.50-0.84) but not for Blacks.

Conclusions: Adults of color with disabilities were less likely to have a USC than their white counterparts. Demographic and economic factors accounted for some, but not all, of the disparities. Efforts to improve healthcare access require a nuanced approach to address variations in disparities among people with disabilities.