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Race/Ethnicity, Educational Attainment, and Foregone Health Care in the United States in the 2007–2009 Recession

Publication Abstract

Burgard, Sarah, and Jaclynn Hawkins. 2014. "Race/Ethnicity, Educational Attainment, and Foregone Health Care in the United States in the 2007–2009 Recession." American Journal of Public Health, 104(2): e134-e140.

This study assessed possible associations between recessions and changes in the magnitude of social disparities in foregone health care, building on previous studies that have linked recessions to lowered health care use. Using data from the the National Health Interview Study (waves 2006-2010), we examine levels of foregone medical, dental and mental health care and prescribed medications. Differences by race/ethnicity and education are compared before the Great Recession of 2007 to 2009, during the early recession, and later in the recession and in its immediate wake. We found foregone care rose for working-aged adults overall in the two recessionary periods compared with the pre-recession. For multiple types of pre-recession care, foregoing care was more common for African Americans and Hispanics and less common for Asian Americans than for Whites. Less-educated individuals were more likely to forego all types of care pre-recession. Most disparities in foregone care were stable during the recession, though the African American–White gap in foregone medical care increased, as did the Hispanic–White gap and education gap in foregone dental care.

Our findings support the fundamental cause hypothesis, as even during a recession in which more advantaged groups may have had unusually high risk of losing financial assets and employer-provided health insurance, they maintained their relative advantage in access to health care. Attention to the macroeconomic context of social disparities in health care use is warranted.

DOI:10.2105/AJPH.2013.301512 (Full Text)

PMCID: PMC3935707. (Pub Med Central)

Country of focus: United States of America.

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