Racial, Gendered and Income-based Inequalities in Health Care Access and Health Status

• In Event: Race, Gender, and Class Roundtables Session
  In Refereed Roundtable (60 minute): 7) Health, Well-Being, and Social Conditions

Abstract

Ongoing racial and socioeconomic disparities in healthcare access and health outcomes continue to be primary issues for research addressing health inequality. While previous studies reveal significant racial and income-based disparities, these factors are frequently analyzed in isolation, thereby concealing the interplay of stratification systems that generate compounded disadvantage. This study uses intersectionality theory to look at how race/ethnicity, income, and gender all work together to create differences in (1) cost-related barriers to health care and (2) self-rated fair or poor health among U.S. adults.
The data for this study are derived from the 2023 Behavioral Risk Factor Surveillance System (BRFSS), a nationally representative survey. Using survey weights, strata, and primary sampling units, analyses make estimates for the population. The study used survey-weighted regression models to look at how race/ethnicity (White, Black, Hispanic), household income, and gender interact with each other. Predictive margins are utilized to assess probabilities among overlapping social positions.
The findings indicate enduring and significant disparities across all three dimensions. Higher income is closely linked to a lower chance of facing cost barriers and having poor health, but it does not get rid of racial differences. Higher-income Black and Hispanic adults frequently indicate more significant cost-related obstacles compared to lower-income White adults, highlighting the limitations of income as a protective resource. Three-way interaction models demonstrate that racial and income disparities differ by gender, revealing that women in marginalized racial groups encounter increased probabilities of health disadvantage, even at elevated income levels.
These results illustrate that health disparities cannot be comprehensively elucidated through unidimensional analyses. Instead, racism, class inequality, and gender inequality all work together to determine who can get care and how healthy they are. Consequently, policies focused exclusively on economic enhancement are improbable to bridge racial health disparities without confronting the systemic inequities ingrained in healthcare systems and wider social institutions.

Author

• Syeda Erena Alam Dola, University of Tennessee