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Race, Ethnicity, and Preventive Services: No Gains for Hispanics: Center for Studying Health System Change

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Changes in preventive care services among Hispanics, African Americans and whites were analyzed using data from the 1996-1997 and 1998-1999 Household Surveys. In 1998-1999, approximately 80 percent of whites and African Americans, but only 68 percent of Hispanics, reported seeing a physician in the previous year. Differences among the three groups were also found in three preventive care indicators: mammography rates, flu shots, and counseling to quit smoking. Less than 71 percent of Hispanic women over age 50 reported receiving a mammogram, compared with 74 percent of white and African-American women over age 50 reported receiving a mammogram. Just over half of older Hispanic adults reported receiving a flu shot, compared with nearly 70 percent of older white adults and 51 percent of African Americans. Significantly, more African American and white smokers than Hispanic smokers were counseled by their physicians to stop smoking in 1998-1999. The number of white and of African-American smokers counseled to quit smoking increased significantly from 1996-1997, but the number of Hispanic smokers counseled did not. The low use of preventive services by Hispanics may be the result of various factors, including lack of health insurance, language barriers and other cultural issues. African Americans, in contrast, have seen improvements in several measures, though they still lag behind whites in others. Insurance coverage expansions may help reduce disparities among racial and ethnic groups, but other efforts are needed. Identifying ethnic groups for monitoring of preventive care services and/or interventions, developing programs that enhance culturally appropriate preventive services, and educating health care providers are all avenues to help reduce these disparities.