Access Disparity and Health Inequality of the Elderly: Unmet Needs and Delayed Healthcare

Authors

Tetsuji Yamada, Department of Economics, Center for Children and Childhood Studies, Rutgers University, The State University of New Jersey, 311 North 5th Street, Camden, NJ 08102, USA. tyamada@crab.rutgers.edu.
Chia-Ching Chen, Department of Epidemiology & Community Health, School of Health Sciences & Practice, New York Medical College, 95 Grasslands Rd., Valhalla, NY 10595, USA. ChiaChing_Chen@nymc.edu.
Chiyoe Murata, Department of Social Science, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 35 Gengo, Morioka cho, Obu-shi, Aichi-ken, 474-8511 Japan. cmurata@ncgg.go.jp.
Hiroshi Hirai, Department of Civil Environmental Engineering, Iwate University, 4-3-5, Ueda, Morioka-shi, Iwate-ken, 020-8551 Japan. hirai181kan@gmail.com.
Toshiyuki Ojima, Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashiku, Hamamatsu-shi, Shizuoka-ken, 431-3192 Japan. ojima@hama-med.ac.jp.
Katsunori Kondo, Center for Preventive Medical Sciences, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba-ken, 260-8670 Japan. kkondo@chiba-u.jp.
Joseph R. Harris, Department of Public Policy and Administration, Rutgers University, The State University of New Jersey, 311 North 5th Street, Camden, NJ 08102, USA. hajoseph@scarletmail.rutgers.edu.

Author Type(s)

Faculty

DOI

10.3390/ijerph120201745

Journal Title

International Journal of Environmental Research and Public Health

First Page

1745

Last Page

72

Document Type

Article

Publication Date

2-3-2015

Abstract

The purpose of this study is to investigate healthcare access disparity that will cause delayed and unmet healthcare needs for the elderly, and to examine health inequality and healthcare cost burden for the elderly. To produce clear policy applications, this study adapts a modified PRECEDE-PROCEED model for framing theoretical and experimental approaches. Data were collected from a large collection of the Community Tracking Study Household Survey 2003-2004 of the USA. Reliability and construct validity are examined for internal consistency and estimation of disparity and inequality are analyzed by using probit/ols regressions. The results show that predisposing factors (e.g., attitude, beliefs, and perception by socio-demographic differences) are negatively associated with delayed healthcare. A 10% increase in enabling factors (e.g., availability of health insurance coverage, and usual sources of healthcare providers) are significantly associated with a 1% increase in healthcare financing factors. In addition, information through a socio-economic network and support system has a 5% impact on an access disparity. Income, health status, and health inequality are exogenously determined. Designing and implementing easy healthcare accessibility (healthcare system) and healthcare financing methods, and developing a socio-economic support network (including public health information) are essential in reducing delayed healthcare and health inequality.

Recommended Citation

Yamada, T., Chen, C., Murata, C., Hirai, H., Ojima, T., Kondo, K., & Harris, J. R. (2015). Access Disparity and Health Inequality of the Elderly: Unmet Needs and Delayed Healthcare. International Journal of Environmental Research and Public Health, 12 (2), 1745-72. https://doi.org/10.3390/ijerph120201745