A significant literature exists regarding the role of patient factors in the causation of racial and ethnic healthcare disparities. Major determinants include healthcare access/insurance status, language dominance, patient health literacy, mistrust of providers, patient preferences and refusal of treatment, and race-based biophysiologic difference. Racial and ethnic disparities in access to medical care are well known among health service researchers (Andrulis, 1998). Previous research has shown consistently that people without health insurance are less likely to receive health care in a timely manner and have lower levels of health services utilization (Andrulis; Bradbury, Golec, & Steen, 2001). In addition, most studies conclude that members of minority ethnic groups are less likely to have insurance and more likely to have insurance related healthcare access problems than Whites (Bradbury et al.; Fiscella, Franks, Doescher, & Saver, 2002; Gaskin & Hoffman, 2000; Hogue, Hargraves, & Collins, 2000; Mayberry, Mili, & Ofili, 2000; Monheit & Vistnes, 2000; Waidmann & Rajan, 2000; Weinick, Jacobs, Stone, Ortega, & Burstin, 2004; Weinick & Krauss, 2000; Weinick, Zuvekas, & Cohen, 2000).
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