Who sees the doctor? A study of urban black adolescents.

Abstract

Abstract By means of structured personal home interviews, health problems and physician care obtained for those problems were studied in an area probability sample of 562 non-Hispanic, black adolescents, drawn from a single health district in a major city in the Northeastern U.S. Physician care was represented by a ratio score: the number of health problems for which the adolescent had seen a physician divided by the total number of health problems he reported. On the basis of these scores, adolescents were separated into “high” and “low” physician care groups and compared with regard to: kinds of health problems, general health status, demographic and family background characteristics, health attitudes and behavior and psychosocial attitudes. Bivariate and then multivariate analyses were performed. A major finding indicated a relationship between lack of medical care and activity limitation or chronic impairment as early as the adolescent years. In multivariate analysis, the variable which accounted more than any other for the difference between black adolescents with “high” and “low” physician care scores was the combination of having a private physician and a mother born outside the southern U.S. Generally the findings supported the model of significant psycho-sociocultural influences, over and above need for care and availability of services, in explaining medical utilization.