Trends in Differences Across Subgroups of Adults in Preventive Services Utilization

Area of Science:

• Public Health
• Health Services Research
• Health Policy

Background:

• Significant disparities in preventive healthcare utilization existed among adult subgroups prior to 2010.
• The Affordable Care Act (ACA) introduced provisions to enhance service use and mitigate health disparities.

Purpose of the Study:

• To assess changes in preventive service utilization over time.
• To examine these changes across diverse adult subgroups (race/ethnicity, insurance, income, region, urbanicity).

Main Methods:

• Utilized Medical Expenditure Panel Survey Household Component data (2008/2009, 2012/2013, 2015/2016).
• Analyzed four key preventive services: general checkups, cholesterol screening, mammograms, and colorectal cancer screening for adults aged 19-64.
• Employed multivariate logistic regression to model utilization and track changes in subgroup disparities.

Main Results:

• Modest increases observed in blood cholesterol and colorectal cancer screenings between 2008/2009 and 2015/2016.
• Regional disparities narrowed for three of four services.
• Persistent significant gaps in utilization were found across income levels and insurance coverage status.
• Racial/ethnic disparities in general checkups remained unchanged.

Conclusions:

• Despite some narrowing of disparities, substantial inequities in preventive care access and utilization persist among adult populations.
• Further targeted interventions are needed to address persistent gaps in preventive service utilization.