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Gay Becker, PhD and Edwina Newsom

The authors are with the Institute for Health and Aging, University of California, San Francisco.

Correspondence: Requests for reprints should be sent to Gay Becker, PhD, Institute for Health and Aging, University of California, San Francisco, Box 0646, San Francisco, CA 94143-0646 (e-mail: becker{at}itsa.ucsf.edu).

Addressing differences in social class is critical to an examination of racial disparities in health care. Low socioeconomic status is an important determinant of access to health care.

Results from a qualitative, in-depth interview study of 60 African Americans who had one or more chronic illnesses found that low-income respondents expressed much greater dissatisfaction with health care than did middle-income respondents.

Low socioeconomic status has potentially deadly consequences for several reasons: its associations with other determinants of health status, its relationship to health insurance or the absence thereof, and the constraints on care at sites serving people who have low incomes.

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