Organizational Affiliation: Rhode Island Department of Human Services & Center for Health Care Strategies
Author: Christine A. Payne
Date: February 2002
Contact Information: N/A
Pages: 57
Content Summary
The purpose of this report was to analyze the needs of Rhode Island 's working age adults with physical disabilities and chronic health conditions who are on fee-for-service Medicaid. The survey assessed prevalence and type of health conditions, health status, health services utilization, and unmet needs of Rhode Islanders on fee-for-service Medicaid. The survey was conducted by telephone in English, Spanish, and Cambodian. This report includes tables and graphs to explain the significant trends in unmet needs for this population. In the appendices to the report there are additional graphs and charts and the entire survey is also included.
Major Findings
The report showed that over 65% of those surveyed reported two or more health conditions and those with respiratory diseases reported the worst health status. An overwhelming 75% of the respondents reported fair or poor health status. And over 75% of those who participated in the survey reported that they had no difficulty obtaining medical care when they needed it. In general, the respondents had more ease obtaining care for acute conditions than chronic conditions. This suggests that more must be done to provide for the unmet needs of those with chronic conditions in the Rhode Island working adult population. The racial and ethnic disparities analyzed in this report were few. The report showed that only 14% of African-Americans reported difficulty in obtaining medical care while 26% of whites and 24% of Hispanics reported having difficulty in obtaining medical care. However, the report also found that 20.4% of African-Americans had a high dependency on formal system for providing care compared to 16.4% of whites and 12.1% for Hispanic. This reveals that less formal systems of support may be less available for African-Americans compared to the other groups. Table A-2 is a detailed table showing the results of the survey in terms of race and ethnicity.
Unaddressed Issues or Concerns
This report did not address racial disparities how access to care does not guarantee equal health care quality. One study found that compared to Whites, Black women reported significantly less bone mass density testing and prescription and nonprescription osteoporosis (Mudano 448). This reveals that the quality of care obtained by racial minorities may be significantly inferior to that obtained by whites. In addition, the report does not address that racial minorities are often more at risk, have higher incidence, and higher prevalence of many chronic conditions. For example, Sharma et al. showed that increased CVD risk factors exist for non-Hispanic Blacks and even when controlling for socioeconomic factors, Mexican Americans and non-Hispanic Blacks have a higher risk for developing CVD than non-Hispanic Whites (Sharma 47). Therefore, access to care cannot be the only factor considered in order to understand racial disparities in health care.
Reference List
Mudano, AS., L. Casebeer, F. Patino, J. Allison, N. Weissman, C. Kiefe, S. Person, D. Gilbert, and K. Saag. "Racial Disparities in Osteoporosis Prevention in a Managed Care Population." Southern Medical Journal. 96.5 (2003):445-51.
Sharma, S; A. Malarcher, W. Giles, and G. Myers. " Racial, Ethnic and Socioeconomic Disparities in the Clustering of Cardiovascular Disease Risk Factors." Ethnic Disparities. 14.1 (2004):43-8.
How to Access Report http://www.dhs.state.ri.us/dhs/reports/Adult%20Needs %20Assessment.pdf