Black Coloradans see the doctor less frequently, get less preventive care and report being in worse health than other residents of the state, according to a recent health survey.
The biennial Colorado Health Access Survey, which polled 10,224 households between April 15 and July 27, provides one of the most comprehensive snapshots of how Colorado residents experience the health care system.
The latest survey, released Tuesday, gives an important look at the current status of health care in the state ahead of a broad set of changes promised by the Affordable Care Act and the expansion of Medicaid.
Around 14 percent of the Coloradans surveyed said they were uninsured, down from around 16 percent in 2011.
But these numbers — and nearly all the information collected in the phone survey — varied widely across regions, income levels, age groups and ethnic groups, highlighting disparities in the way Coloradans receive medical care.
Only 5.3 percent of the people living in Douglas County didn’t have any insurance, for example, while in Northwest Colorado, a region that includes Routt, Moffat, Rio Blanco and Jackson counties, around 25 percent were uninsured.
Hispanics were the most likely to be uninsured. Around 22 percent of Latinos polled in the latest survey said they didn’t have any insurance. Still, more Hispanics had insurance than just two years ago, when 26 percent said they were uninsured.
Roughly 12 percent of non-Hispanic whites were uninsured, down from 13 percent in 2011.
By contrast, a growing number of African Americans reported being uninsured than in the past. Roughly 20 percent of those surveyed said they were uninsured, up sharply from 14 percent in 2011. The trend marked continued erosion in the ranks of the insured in Colorado’s small African-American community. In 2009, only 12 percent of African Americans surveyed said they didn’t have insurance.
At the same time, black Coloradans were increasingly less likely to report having seen a general doctor in the previous year or to have received preventive care. And around 19 percent of African Americans in the state said they used the emergency room as their primary source of care, compared with 5.7 percent of the population as a whole.
Grant Jones, executive director of the Denver-based Center for African American Health, said the information was surprising.
“At a time when we’re moving toward greater access and coverage and quality of care,” Jones said, “it’s alarming to see fewer people accessing care and seeing a doctor on a regular basis in the African American community.”
But African Americans weren’t skipping the doctor because they were healthier, the findings suggests. Instead, fewer black people in Colorado reported being in excellent health than other communities, while more reported being in poor health.
Black Coloradans were more likely than others to cite cost as a barrier to care, or to say they didn’t seek an appointment because they were uninsured, according to the Colorado Health Institute’s analysis of the survey. They were also more likely to say that they couldn’t get a doctor’s appointment in time, had trouble getting transportation or couldn’t get time off work.
“There’s lots of good research that points to the benefits of having primary and preventive care,” says Jeff Bontrager, director of research on coverage and access for Colorado Health Institute.
More doctor visits means more immunization for kids, early screening for cancer, mammograms and the chance to develop a relationship with a doctor, Bontrager notes. That’s the kind of health care that not only treats illness but stops it from developing in the first place.
The wide health discrepancies across the state provide an invitation to dig deeper into the causes and consequences, says Gretchen Hammer, executive director of the Colorado Coalition for the Medically Underserved.
“I don’t think this gives us the answer of why,” says Hammer. “It directs us to engage in these communities and see what they’re experiencing.”
Jones believes that the Affordable Care Act should help improve access to care among African Americans. But he says more should be done to focus on the communities that aren’t receiving adequate care.
“If we could make a dent in improving outcomes for African Americans and Latinos,” says Jones, “it would lift the status of our state in a dramatic way.”
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“At a time when we’re moving toward greater access and coverage and quality of care, it’s alarming to see fewer people accessing care and seeing a doctor on a regular basis in the African American community.”
Executive director of the Denver-based Center for African American Health