Job and Wealth Loss and Racial / Ethnic Disparities in Health Services Use: a State-Level Examination

Racial and ethnic minorities were disproportionately affected by the “Great Recession” of 2007- 2009. African Americans and Hispanics experienced significant losses of employment, income, health insurance and wealth. The mechanisms through which these losses affected health care services use and exacerbated racial/ethnic disparities in use during the recession have not been examined. We will use data from the Medical Expenditure Panel Survey (MEPS) from 2005- 2006 and 2008-2009 to examine the relationship between state-level losses in employment, insurance, income and wealth during the 2007-2009 recession and physician visits, prescription drug fills, inpatient stays and emergency department utilization of whites, blacks, and Hispanics. Negative binomial models will be estimated to identify variation in utilization patterns and relationships with state-level factors affected by the recession across states by race/ethnicity. Patterns will then be modeled separately for each race/ethnicity to determine differential pathways that state-level factors have on health services use of minorities. We will specifically identify health services utilization during the recession and 1) the relationship between job loss and the resulting loss of income and health insurance, and 2) the effects of losses in wealth during the housing crisis. We seek to determine if one or both of these mechanisms are related to overall reduced health services use during the recession, and disproportionate reductions in minorities’ health services use.