"Beyond Coverage: Enhancing Healthcare Access for Non-Hispanic Black and White Men"

Despite the ACA's success in improving insurance coverage for both non-Hispanic Black men and non-Hispanic White men, the proportion of these groups with a usual source of care remains insufficient. This unexpected finding is concerning, as it is well-established that having health insurance typically leads to having a regular healthcare provider, which in turn, can result in better health outcomes (Davis, 2001; DeVoe et al., 2011; KFF, 2016).

To effectively increase the number of men with a usual source of care, a multilevel strategy is essential. This involves: a) promoting educational campaigns to raise awareness among men about the importance of having a regular healthcare provider, and b) implementing healthcare delivery and payment reforms that encourage institutions to engage more Black men in regular care.

Research highlights that, despite improved health insurance coverage post-ACA, fewer men reported having a usual source of care. Non-Hispanic Black men, in particular, were less likely than their White counterparts to have regular care, indicating persistent structural racism as a barrier. Addressing this requires interventions at multiple levels, targeting both systemic and individual factors.

The National Institutes of Minority Health and Health Disparities (NIMHD) champions multilevel research to inform effective policies and practices. Their framework is instrumental in addressing health disparities through comprehensive approaches, as demonstrated in various studies showing improved health outcomes for marginalized populations.

Recommendation 1a:

Raising awareness about the importance of regular healthcare among men, especially Black men, can be achieved through targeted educational messages in settings like barbershops, educational institutions, faith-based organizations, and social media. Studies have shown significant health improvements when interventions are delivered in these contexts. Additionally, involving older Black men as mentors and incorporating family support can enhance health-seeking behaviors among younger men.

Recommendation 1b:

Healthcare delivery reforms, such as patient-centered medical homes and accountable care organizations, incentivized by the ACA, can support better care for Black men. Federally qualified health centers (FQHCs) also play a crucial role in providing primary care. Addressing implicit biases in healthcare providers is vital for fostering trust and effective communication with Black male patients.

Legislation like the Health Equity and Accountability Act of 2022 should include provisions addressing the unique healthcare needs of men, akin to those for women. Establishing an Office of Men’s Health could focus on targeted outreach and improving healthcare access for men. The Men's Health Awareness and Improvement Act of 2021 proposes such an office, highlighting the need to understand and address healthcare underutilization among men.

Overall, a multilevel approach is critical to overcoming barriers and ensuring that more men, particularly Black men, have a usual source of care, ultimately leading to better health outcomes.