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Primary Care Experience and Racial Disparities in Self-Reported Health Status

From the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

Correspondence: Address correspondence to Leiyu Shi, DrPH, MBA, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway/Room 409, Baltimore, MD 21205-1996 (e-mail: lshi{at}jhsph.edu)

Abstract

Context: Access to high quality primary care was identified by Healthy People 2010 as one of the mechanisms through which racial and ethnic disparities in health might be reduced. Despite the well-established connections between good primary care and health, the scientific evidence on whether good primary care can reduce racial disparities in health is sparse.

Objective: To examine whether better primary care experience can attenuate racial and ethnic disparities in self-reported health status.

Data Sources: The 1996 to 1997 and 1998 to 1999 data from the Community Tracking Study (CTS) sponsored by the Robert Wood Johnson Foundation.

Study Design: Cross-sectional, bivariate, and multivariate analyses of inter-relationships between self-rated general and mental health status, access to and interpersonal relationship with primary care provider, and vulnerability measured by race and poverty status.

Results: We found that higher quality primary care levels are associated with reduced racial and ethnic disparities in health status, as measured by self-rated general and mental health. This relationship is particularly pronounced for the racial and ethnic minorities living at or below poverty level. Based on the data from 1996 to 1999, the study also confirmed the presence of significant and persistent health differences across racial and ethnic groups.

Conclusion: Promoting primary care may be a viable approach toward reducing racial and ethnic disparities in self-reported health status.

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