Paper
Wednesday, July 21, 2004
Health Service Use in Three Racial/Ethnic Groups
Karen Aroian, RN, PhD, CS, FAAN, Family, Community, and Mental Health Nursing, Wayne State University, Detroit, MI, USA and Jillon Vander Wal, PhD, Center for Health Research, Wayne State University, Detroit, MI, USA.
| Learning Objective #1: A complete conceptual view of formal health service use in racial/ethnic minorities that includes norms about self-care and personal health responsibility |
| Learning Objective #2: Greater direction on future research needed for health policy to reduce problems with health providers and health disparity in African-Americans |
Introduction/rationale: Immigrants and minorities under use health services. Problems with health care providers is one potential reason. However, immigrants and minorities may also under use health services because of different norms for self-care and personal health responsibility. Research Questions: (1) After controlling for the covariates of health status, age, gender, financial comfort, and education, do three racial/ethnic groups (African Americans, Caucasians and Russian immigrants) differ in problems with providers, self-care, health responsibility, and health service use? (2) Among the aforementioned variables, are there different predictors of health service use for each of the three ethnic/racial groups after controlling for the covariates? Methods: The SF-36, a daily health diary, and a health questionnaire were administered to 309 elders representing the three groups. Data analysis included ANCOVA with Bonferonni corrected contrasts and blocked stepwise multiple regression analyses that controlled for the covariates. Results: Results revealed significant between group effects for self-care, health responsibility, problems with providers, and health service use. Russians had greater health service use and self-care behaviors than African Americans and Caucasians. African Americans had more provider problems and personal health responsibility than either Russians or Caucasians. Health status was the strongest significant predictor of health service use for all three groups. After controlling for the covariates, self-care, health responsibility, and provider problems were not significant predictors of health service use for Russians or Caucasians and self-care was the only significant predictor of health service use for African Americans. Implications: Findings suggest that African Americans do not substitute self for formal care. Their greater problems with providers and personal health responsibility are also not related to their use of formal health services. Future research should investigate whether provider problems affect quality of care for African Americans. Answering this question will direct health policy to reduce health disparities in African Americans.
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Sigma Theta Tau International
July 21, 2004