Examining Racial/Ethnic Disparities in Tobacco Dependence Treatment Among Medicaid Beneficiaries Using Fifty State Medicaid Claims, 2009 –2014

The objective is to estimate racial/ethnic differences in TDT use among Medicaid fee-for-service beneficiaries. Using a retrospective study design and 50 state (including the District of Columbia) Medicaid claims (2009 –2014), we employed multivariable logistic regression models and predictive margin methods to estimate TDT use rates among adults (18–64) enrolled (≥ 11 months) in Medicaid fee-for-service programs (January 2009–December 2014) by race/ethnicity. The population included White (n = 6,536,004), Black (n = 3,352,983), Latinx (n = 2,264,647), Asian (n = 451,448), and Native American/Alaskan Native (n = 206,472) beneficiaries. Dichotomous outcomes reflected service use in the past year. Any TDT use was operationalized as any smoking cessation medication fill, any smoking cessation counseling visit, or any smoking cessation outpatient visit. In secondary analyses, we disaggregated TDT use int o three separate outcomes. Results suggested that Black (10.6%; 95% CI = 9.9–11.4%), Latinx (9.5%; 95% CI = 8.9–10.2%), Asian (3.7%; 95% CI = 3.4–4.1%), and Native American/Alaskan Native (13.7%; 95% CI = 12.7–14.7%) beneficiaries had lower TDT use rates compared to White ben eficiaries (20.6%). Similar racial/ethnic treatment disparities were identified across all outcomes. By identifying significant racial/ethnic disparities in TDT use between 2009 and 2014, this study provides a benchmark against which to measure recent in...
Source: Journal of Racial and Ethnic Health Disparities - Category: International Medicine & Public Health Source Type: research