Poster #107 - Structural Racism and Preventive Care Disparities in Black Americans' Health Outcomes

• In Event: Saturday Poster Luncheon

Abstract

Introduction

Racial disparities in preventive care utilization remain a persistent challenge in the U.S. healthcare system, with Black individuals facing significant barriers to accessing essential services such as general health checkups, oral care, and mental health assessments. Rooted in historical and systemic inequity, including segregation, discriminatory policies, and medical mistrust, these disparities are further exacerbated by socioeconomic factors, implicit bias, and structural racism.

Research Questions

This research seeks to address the following research questions: 1) To what extent does race influence the utilization of preventive care services (general health checkups, oral health visits, and mental health assessments) among Black individuals compared to White individuals? 2) How do socioeconomic factors (income, education, insurance status) mediate the relationship between race and preventive care utilization?

Method

This study examines disparities in three key preventive care outcomes: general health condition, oral health checkup, and mental health assessments among Black and White adults using the 2017 National Health and Nutrition Examination Survey (NHANES) dataset. Grounded in Critical Race Theory (CRT), we assess how structural racism and socioeconomic factors shape disparities.

Results

Multinomial and logistic regression analyses reveal significant racial inequities. For general health checkups, White individuals had 25% higher odds of receiving care compared to Black individuals (OR=1.25, 95% CI[1.03,1.52], p=0.024). In mental health services, Whites showed significantly greater utilization (β=0.267, p=0.008), with education (β=0.230, p=0.016) and insurance (β=-0.488, p=0.004) emerging as key predictors.

For oral health, Black individuals were more likely to experience delayed check-ups (>6 months) (β=-0.282, p<0.001). Socioeconomic factors strongly influenced outcomes: higher education reduced delayed dental visits (β=-0.306, p<0.001), while lower income predicted poorer oral care (β=-0.067, p<0.001).

Multinomial regression for self-reported health showed Whites had significantly lower odds of reporting only Fair (β=-0.438, p=0.012) or Good (β=-0.538, p=0.002) health versus Poor health, but no race differences emerged for Very Good/Excellent categories. Age and income consistently predicted better health status (e.g., older age β=-1.296, p<0.001 for Very Good health; income β=0.171, p<0.001).

Conclusion

Persistent racial disparities in preventive care utilization across all three preventive care domains highlight the enduring effects of structural racism and socioeconomic marginalization. Policy interventions must address both systemic inequities (e.g., bias in healthcare delivery) and socioeconomic barriers (e.g., insurance access, affordability) to ensure equitable preventive care access. Culturally tailored outreach and CRT-informed antiracist healthcare reforms are critical to reducing these disparities.

Author

• Sarah Adi Paul, University of North Carolina, Charlotte
  Presenting Author