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Member Research & Reports

Member Research & Reports

Maryland Study Identifies Reasons Why Minority Cancer Survivors Delay Medical Care

Minority cancer survivors are more likely than White survivors to delay or forgo medical care because of cost, organizational, and transportation barriers, according to a new study led by Dr. Christopher J. King, at the University of Maryland School of Public Health.

Published in the American Journal of Medical Quality, the analysis uses a nationally representative sample to examine the predicted probability of delaying care by race and ethnicity. Using merged data from the 2000-2011 National Health Interview Surveys, the sample size consisted of 12,125 cancer survivors ages 18-64. The Fairlie decomposition technique was applied to identify socio-demographic factors that contributed most to the disparities.

Over the 11-year period, the researchers discovered that minorities were more likely than Whites to delay care because of all barriers combined. Furthermore, the predicted probability of not receiving timely care because of each barrier was highest among minorities. Hispanics and African-Americans were more likely than Whites to delay care because of cost. Lack of insurance, poor health, and comorbidities among minority populations were significant factors that contributed to cost barriers.

Hispanics were more likely than Whites to delay care because of organizational barriers (i.e., could not get an appointment soon enough, office not open when available, wait is too long, could not get through on the phone). Access to insurance and nativity (born outside of the United States) were significant contributors to organizational barriers among Hispanics. African-Americans were more likely to delay care because of transportation barriers.

“Decomposing Differences in Medical Care Access Among Cancer Survivors by Race and Ethnicity” was written by Dr. Christopher J. King, Dr. Jie Chen; Dr. Rada K. Dagher; Dr. Cheryl L. Holt; and Dr. Stephen B. Thomas. The article was published in the American Journal of Medical Equality, and first appeared online on June 5. The online version of the article can be found at