Health Care Use and Health Care‒Amenable Mortality Among US Adults With and Without a Bachelor's Degree, 1996‒2023.
Objectives. To describe health care‒related educational divides in 2 dimensions—outpatient care utilization and medically preventable deaths—over the past 25 years. Methods. We examined education-based disparities in ambulatory care utilization by analyzing data on 476 277 respondents aged 25 years...
| Publicado en: | American Journal of Public Health Vol. 116; no. 5; pp. 692 - 702 |
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| Autores principales: | , , , , , |
| Formato: | Artículo |
| Publicado: |
American Public Health Association
May2026
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=192845808&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 192845808 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00900036 APH jtl: American Journal of Public Health issn: 00900036 maglogo: N pubinfo: dt: May2026 vid: 116 iid: 5 pid: 44 pub: American Public Health Association artinfo: ui: 192845808 10.2105/AJPH.2025.308373 ppf: 692 ppct: 10 formats: tig: atl: Health Care Use and Health Care‒Amenable Mortality Among US Adults With and Without a Bachelor's Degree, 1996‒2023. aug: au: Gaffney, Adam Woolhandler, Steffie Dickman, Samuel L. Schrier, Elizabeth McCormick, Danny Himmelstein, David U. affil: Harvard Medical School and the Department of Medicine at the Cambridge Health Alliance, Cambridge, MA. City University of New York Hunter College, New York, NY. Planned Parenthood Montana. Department of Medicine at the University of California San Francisco. su: United States Mortality Health services accessibility Cross-sectional method Outpatient medical care Patient care Health equity Educational attainment Patients' attitudes Medical care costs Mortality prevention Medical care use Poisson distribution Outpatient services in hospitals Undergraduate programs Descriptive statistics Surveys Death certificates Confidence intervals Data analysis software Nosology sug: subj: Mortality Health services accessibility Cross-sectional method Outpatient medical care Patient care Health equity Educational attainment Patients' attitudes Medical care costs United States Community health centres All Other Outpatient Care Centers All other out-patient care centres Mortality prevention Medical care use Poisson distribution Outpatient services in hospitals Undergraduate programs Descriptive statistics Surveys Death certificates Confidence intervals Data analysis software Nosology ab: Objectives. To describe health care‒related educational divides in 2 dimensions—outpatient care utilization and medically preventable deaths—over the past 25 years. Methods. We examined education-based disparities in ambulatory care utilization by analyzing data on 476 277 respondents aged 25 years or older to the 1996–2022 US Medical Expenditure Panel Survey, and in deaths potentially preventable by medical care (defined by International Classification of Diseases, 10th Revision , code) from 26 092 720 death certificates of individuals aged 25 to 74 years in the United States from 2001 to 2023. Results. In 1996, the share of adults with zero provider visits was higher among those without (26.4%; 95% confidence interval [CI] = 25.3, 27.5) than with (20.2%; 95% CI = 18.5, 22.0) a bachelor's degree, a gap that widened to a nearly 2-fold difference by 2022; the gap in the proportion with no doctor visit also widened. Disparities in health care use were larger after adjustment for health factors. Separately, we observed large and growing education-based gaps in age-adjusted health care‒amenable mortality. Conclusions. Education-based disparities in ambulatory health care utilization have grown since 1996, as have medically preventable deaths. Public Health Implications. Improved health care access for less-educated Americans might help address widening disparities in ambulatory health care use and, potentially, health outcomes. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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