However, there is also evidence that racial differences remain among older adults in access to health services ( Gornick, 2000). For instance, Decker and Rapaport (2002) show that turning 65 increases the chances of having a mammogram among black women, particularly uneducated black women. Medicare has indeed improved the situation for older adults. This requirement played a large role in desegregating hospitals ( Quadagno, 2000). To participate in this program, hospitals had to comply with Title VI of the Civil Rights Act of 1964, which requires that no one be excluded from federal benefits based on race, color, or national origin. In 1965, the Medicare program was established to reduce financial barriers to hospital and physician services for persons aged 65 and older. Moreover, this study found that, even if income and health insurance coverage were equal, racial and ethnic differences in having a usual source of care and in receiving ambulatory care in the previous year would not have been eliminated, because one-half to three-quarters of the differences on these indicators were not accounted for by income and insurance coverage. Analyses of racial and ethnic differences in access to and the use of health services between 19 show that the black-white gap has not narrowed over time, and the gap between Hispanics and whites has widened ( Weinick et al., 2000). Blacks and Hispanics are also more likely than whites to receive care in nonoptimal organizational settings (such as emergency rooms) and to lack continuity in health care. Adults Aged 18-64, 2001.īlacks and Hispanics are less likely to have insurance coverage from a private employer, whether directly or through a spouse, and more likely to have public health insurance coverage than whites ( Blendon et al., 1989 Hogue et al., 2000 National Institutes of Health, 1998).
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