Preventive care in the United States: are blacks finally catching up?

Objective: To evaluate rates of preventive care among Blacks in specific demographic categories, such as age, income, gender, and Caribbean descent.

Design, Setting, And Participants: Data from the Commonwealth Fund 2001 Health Care Quality Survey, conducted from April through November 2001, which involved telephone interviews with a nationally representative sample of 6,722 adults age 18 and older living in the continental United States. Analysis focuses on the subset of Black respondents in comparison to Whites and Hispanics (n=5678).

Main Outcome Measures: Rates of preventive care including primary care visits, cholesterol and blood pressure screening, diabetes care, and cancer screening.

Results: Blacks have rates of preventive care comparable to those of Whites, with higher rates for some services. Overall, Blacks did better than Hispanics for most of the preventive measures studied. An evaluation of specific demographic subgroups of Blacks shows that certain populations, such as men and the uninsured, have lower rates of some preventive care measures. For example, Black men are less likely to report having a physical exam than Black women (odds ratio [OR] 0.53, 95% confidence interval [CI] 0.37-0.77) as well as less likely to report blood pressure screening in the prior year (OR 0.58, 95% CI 0.34-0.98).

Conclusions: While high levels of mortality persist, Blacks fare relatively well in terms of selected preventive care services. Although focus on prevention is still a key concern, evaluating other causes of increased mortality, including differences in follow-up, referral, and quality of care, is also important.