Title: 2 Factors That Affect Health-Care Utilization | Health-Care Utilization as a Proxy in Disability Determination | The National Academies Press
Headings: 
2
Factors That Affect Health-Care Utilization
NEED FOR HEALTH-CARE SERVICES
ACCESS TO HEALTH CARE
Ability and Propensity to Use Services
Insurance and Ability to Pay for Services
DIFFERENCES IN HEALTH-CARE UTILIZATION ASSOCIATED WITH SELECTED CHARACTERISTICS
Race and Ethnicity
Sex
Working Age Adults
Spoken Language
Income and Poverty
Geography
Sociodemographic and Characteristics
Risk Factors
Utilization
Access
Geographic Practice Patterns
PEOPLE WITH DISABILITIES
SUMMARY AND CONCLUSIONS
REFERENCES

Content: However, the committee did examine national data when they were available. Need for and access to health care are discussed below. Those sections are followed by a discussion of differences in utilization according to selected characteristics. Finally, health-care utilization by people who have disabilities is discussed. NEED FOR HEALTH-CARE SERVICES
Health status and the need for health-care services to improve or maintain health are major determinants of health-care utilization. The World Health Organization states that health is determined by a person’s individual characteristics and behaviors, physical environment, and socioeconomic environment ( WHO, 2017 ). People’s individual characteristics include their biology and genetics, such as inherited diseases and conditions that require medical care. The prevalence of those conditions differs by sex, age, race and ethnicity, employment status, and other factors. Physical environments can affect health because of pollutants or other environmental health hazards. Individual behaviors, such as smoking or lack of exercise and overeating, also cause health conditions that require health care ( ODPHP, 2017a ).