The impact of multiple social categories on health care outcomes.
Item
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Title
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The impact of multiple social categories on health care outcomes.
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Identifier
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AAI3103159
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identifier
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3103159
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Creator
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Perkins, Tiffany Sabrena.
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Contributor
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Adviser: Deborah L. Coates
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Date
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2003
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Language
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English
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Publisher
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City University of New York.
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Subject
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Psychology, Social
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Abstract
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Research has often neglected the interconnected nature of social categories. The purpose of this secondary data analysis was to examine the individual and interactional effects of three social categories, gender, poverty, and disability, on various healthcare outcomes: (a) type of insurance, (b) type of provider, (c) perceived health status, (d) satisfaction with usual source of care, and (e) comprehensiveness of services.;The 2,076 African American participants were part of the Agency for Health Research Quality's Medical Expenditure Panel Survey, a nationally representative survey that collects detailed information on the health status, access to care, healthcare use, expense, and health insurance coverage of the civilian noninstitutionalized population of the United States. It was designed to help understand how changes in public and private health insurance, and other dynamics of today's market-driven healthcare delivery system continue to affect the kinds, amounts, and costs of American healthcare.;The model that included the individual effects of gender, poverty, and disability predicted type of insurance and perceived health status. When two-way interactions between social categories were introduced, the model predicted type of insurance and perceived health status. Finally, when the gender-poverty-disability interaction was added, the model predicted type of insurance and comprehensiveness of services, which was not significant in the model of individual effects or in the model of two-way interactions. Subsequent analyses indicated that the relationships between poverty and the two variables of perceived health status and type of insurance changed significantly, depending upon whether or not the respondent had a disability.;As a summary point, the comparison of all low status levels within social categories (e.g., women with a disability in the lowest poverty category) to all high status levels (e.g., men without a disability in the highest poverty category) indicated that respondents who represented all high status levels within social categories had better healthcare outcomes than respondents who represented all low status levels within social categories. The implications of the findings are that individuals who belong to low status levels within social categories are more likely to be targets of institutional discrimination. However, this holds true for certain variables and not for others, suggesting the need to look not only at multiple social categories, but also at the role played by different types of outcomes.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
