Self-advocacy during the medical encounter: use of health information and racial/ethnic differences

Med Care. 2006 Feb;44(2):100-9. doi: 10.1097/01.mlr.0000196975.52557.b7.


Background: Research indicates that patients who self-advocate during the medical encounter gain maximum benefit. However, little is known about racial/ethnic differences in self-advocacy.

Objective: We sought to examine whether race/ethnicity and obtaining health information are associated with self-advocacy (mentioned health information to physician and physician ordered tests based on health information).

Methods: Study data were drawn from the 2000-2001 Household Component of the Community Tracking Study, a nationally representative survey. The study sample included 7419 women ages 45 to 64 who had at least 1 physician visit in the previous year. Binomial logit models were used to assess self-advocacy. Probability adjustments were applied to results.

Results: In the full sample (n = 7419), women who obtained health information were almost 5 times more likely to mention that information to their physician (odds ration [OR] = 4.76, 95% confidence interval [CI] 4.05-5.60) than women who did not obtain information. Black women were less likely to mention health information to their physician (OR = 0.52, 95% CI = 0.37-0.73) than white women. Among women who obtained health information (n = 3690), black women also were less likely to mention health information to their physician (OR = 0.57, 95% CI = 0.40-0.83) than white women. Among those who mentioned health information to the physician, Hispanic women were more likely than white women to have a test/procedure/prescription prescribed (OR = 2.15, 95% CI = 1.10-4.20). However, after adjusting probability, this difference was not statistically significant.

Conclusions: Although health information was associated with self-advocacy, black women were less likely to self-advocate. Further research is needed to better understand factors that impede black women from self-advocating.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Age Factors
  • Black or African American*
  • Female
  • Health Education / methods*
  • Health Knowledge, Attitudes, Practice*
  • Hispanic or Latino*
  • Humans
  • Middle Aged
  • Physician-Patient Relations*
  • Socioeconomic Factors