Orr ST, Miller CA, James SA.
Differences in use of health services by children according to race. Relative importance of cultural and system-related factors.
Med Care 1984; 22(9):848-53.

“Black children make substantially less use of health services than do their white counterparts, despite their demonstrably poorer health status. This relationship is true regardless of income.”

“The present study compared use of health services by black and white children within a system of care that has sought to decrease barriers to access to care by black children.”

Within this system, “black children made more use or equal use of health care than did white children. These findings indicate that availability of care is probably a very strong determinant of health service utilization and may be a more important than health-related beliefs or cultural norms.”