Health Disparities Hit Poor, Minority Women

New America Media, News Report, Paul Kleyman, Posted: Dec 02, 2009 

Low-income women not yet old enough for Medicare are four times more likely to be in poor or fair health—especially those in middle age and from ethnic backgrounds—according to a new report by the Center for Health Policy Research at the University of California, Los Angeles.

The data was collected in 2007, before the recession, “which means that their status is likely to be even worse today," said study coauthor Roberta Wyn, associate director of the center. 

Poor women in the study were less likely to see a physician: Only one in five reported not visiting a doctor in the previous year, compared with one in 12 more affluent women.

They were less apt to receive preventive screenings, such as for cervical and breast cancer, especially those between ages 40 and 64.

They were also less likely than affluent women to have health insurance.

Because the study looked at an expansive database of 3.8 million women in California, the report carries national implications. The researchers examined data from the California Health Interview for women with family incomes below 200 percent of the federal poverty level (FPL). 

The report, “Health Disparities Among California's Nearly Four Million Low-Income Nonelderly Adult Women,” shows that health disparities were particularly pronounced for women ages 40 to 64. That group had higher rates of diabetes, high blood pressure, asthma and heart disease than women with family incomes at or above quadruple the federal poverty line. 

“Women with family incomes 200 to 399 percent of the FPL also have higher rates of these health conditions than higher income women,” said the researchers. 

The report also noted that while 16 percent of nonelderly white women (ages 18 to 64) were poor, Latina and Native American women were the most likely to have limited family incomes. “Nearly six in 10 Latinas (58 percent), 47 percent of American Indian/Alaska Native women, 41 percent of African-American women, 28 percent of Asian/Pacific Islander women and 29 percent of multiple-race women have low incomes,” according to a UCLA summary.

In light of the recent controversy over whether women should have annual mammograms in their 40s, the UCLA researchers found that low-income women were “the least likely to have received a timely mammogram” at all. In 2007, almost one in three low-income women between 40 and 64 had not received a mammogram within the past two years, “a proportion twice that of higher-income women,” the study found.

Mammogram screening levels were higher for women in their 50s than for those in their 40s, probably because of longstanding ambivalence about providing tests to those before the age of 50, researchers said.

Women in the study also experienced “inadequate access to health insurance and health care to a far greater degree than their higher-income counterparts,” Wyn added. "Women, especially in poor families, are often breadwinners whose good health is essential to keeping their families afloat," Wyn said.

Also striking was the finding that “low-income women are more likely to report a health condition that limits basic physical activities, such as walking, climbing stairs, lifting or carrying.” Women at poverty levels were also more apt to report having difficulty performing basic daily activities, such as dressing, bathing or getting around the house.

In stressing the importance of preventive practices for low-income women, the report explains that poor women are much less likely than more affluent women to maintain a healthy weight or to exercise, and were more likely to smoke. The authors stressed that “proactive policies and programs that promote healthy environments can remove some of the obstacles” to improving their health.

The study concluded that for lower-income women, “their limited discretionary income, combined with their poorer health status, reinforces the urgency of effective and consistent health insurance coverage and access to health services for all.”

Read the report online.