Disparities in receipt of high-priority clinical preventive services

The purpose of this paper is to examine potential disparities in the receipt of high-priority, clinical preventive services among adults.

The study is based on a cross-sectional survey from the Agency for Healthcare Research and Quality (AHRQ) Medical Expenditure Panel Survey (MEPS), 2018 and includes non-institutionalized adults age ≥ 35 in the United States (n = 14,615). The primary outcome measure is a composite measure that assesses receipt of fifteen high-priority clinical preventive services.

Results provide the first national estimates of disparities in receipt of all recommended high-priority preventive services. Receipt of all recommended preventive services among adults age ≥ 35 was low (6%). Multivariable regression analysis found sizable disparities associated with all sociodemographic characteristics examined. Black adults were 37% less likely than white adults (OR: 0.63, CI 0.46-0.86); those with a high school education or less were less than half as likely as college graduates (≤ HS OR: 0.44, CI 0.32-0.61, HS grad OR: 0.46, CI 0.36-0.59); poor and low income individuals were much less likely than those with higher incomes (Poor OR: 0.66, CI 0.48-0.90, low income OR: 0.70, CI 0.53-0.92); the uninsured were 89% less likely than those with private insurance (OR: 0.11, CI 0.04-0.27); adults who spoke a language other than English had 35% lower odds than those who spoke English (OR: 0.65, CI 0.45-0.95) to receive all high-priority services.

Improving population health depends upon effective strategies to increase uptake of high-priority preventive services while reducing disparities in receipt of these services.