The purpose of this study was to describe differences in health status and in health care access and use among white, black and Hispanic adolescents in the United States and to evaluate how such differences are influenced by health insurance. Data for this study were derived from the 1988 National Health Interview Survey.

Non-white adolescents were significantly less likely than white adolescents to be in excellent or very good health, but white adolescents had the highest number of "bed days." Additionally, Hispanics had the highest number of school-loss days. Black and Hispanic adolescents had fewer ambulatory care contacts; however, there was no racial difference in the proportion of adolescents who had seen a doctor within the last two years. In the multivariate analysis, having insurance was associated with a notable increase in the number of physician contacts for each race but did not completely explain the racial variation. Having insurance was also associated with having seen a doctor in the last two years. Among the insured, blacks were more likely to meet these criteria (83% of blacks versus 78% of both whites and Hispanics). Insurance was not associated with continuity form routine to acute care and did not eliminate racial disparities in this area. (Blacks were less likely to experience such continuity.)

In sum, black and Hispanic adolescents had greater health needs and access problems than they white peers. However, after controlling for predisposing and need factors, black and Hispanic youth were actually more likely than white youth to be in compliance with established recommendations for a routine doctor visit at least every two years. Additionally, black and Hispanic adolescents in this study were reported to have fewer bed days than whites despite their worse perceived health status. The authors suggested that these patterns might be explained by possible cultural differences in reporting, in addition to social and institutional factors.

Racial differences in health care access and use were found to be due in part to a lack of health insurance. However, insurance did not completely explain race patterns. "It appears that universal health coverage alone will not resolve racial disparities in use of physician services." The authors suggest that different beliefs regarding health, as well as discrimination in terms of institutional access or physician behavior could be an explanation.

The authors conclude that this study demonstrated that black and Hispanic youth are more likely to seek preventive and less likely to seek acute care than whites; however, the reasons why are not clear. They also note that that this study underscores the importance of health insurance, which substantially increased appropriate health care use, as well as access to sources of routine care.