Disparities in Access and Use of Health Care among Individuals with Disabilities: Are Minority and Low SES Individuals Doubly Disadvantaged?

Background: Health care disparities continue to exist despite multiple layers of governmental intervention and research. Evidence of disparities among persons who are disabled is relatively scant.

Methods: The data were drawn from the Medical Expenditure Panel Survey (MEPS) from years 2001 to 2007. The sample (n = 10,477) consists of adults 18 to 64 years of age with at least one of six types of disability, based on the ICF. We examined disparities among persons with disabilities vis-ŕ-vis several access and utilization measures and individual-level measures such as race, gender, SES, marital status, and insurance type.

Results: A majority of the sample is White, female, middle-aged, less than or high-school educated, and has private health insurance. Blacks had the highest proportion of disability in 5 of 6 disability categories, while Whites had the highest proportion in only one category (sensory) and the lowest on the remaining categories. Among individuals with disabilities, Blacks and Hispanics had greater proportions of respondents (relative to Whites) who had difficulties with access to a usual source of care. Minorities also were more likely to perceive difficulties with being listened to and receiving respect from providers. Use of the ED was notably higher among Blacks, relative to both Whites and Hispanics. There was a strong association between SES and access and use of services.

Conclusions: The findings confirm previous literature regarding health care disparities among minorities without disabilities. There is evidence that Blacks and low SES individuals with disabilities may be ‘doubly disadvantaged.'