Official websites use .gov
Secure .gov websites use HTTPS
Black and African American adults’ perspectives on discrimination and unfair judgment in health care
Black and African American adults’ perspectives on discrimination and unfair judgment in health care
- Collection:
- Health Policy and Services Research
- Author(s):
- McDaniel, Marla, author
Richardson, Audrey, author
Gonzalez, Dulce, author
Alvarez Caraveo, Clara, author
Wagner, Laura, author
Skopec, Laura, author
Robert Wood Johnson Foundation, author. - Contributor(s):
- Urban Institute, issuing body.
- Publication:
- Washington, DC : Urban Institute, August 2021
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Black or African American -- statistics & numerical data
COVID-19
Healthcare Disparities -- statistics & numerical data
Racism -- statistics & numerical data
United States - Genre(s):
- Technical Report
- Abstract:
- Study after study confirm that the health care system treats people unequally and patients’ care and outcomes vary markedly by race (AHRQ 2020; National Research Council 2004). Though studies of racial equity often focus on disparities in health care access and outcomes, fewer studies examine discrimination in patients’ day-to-day interactions with the health care system and the similarities and differences in patients’ perceptions, stories, and encounters (Kressin, Raymond, and Manze 2008; Shavers et al. 2012). The COVID-19 pandemic has prompted greater attention to racial inequity in the health care system and both its complex contributing factors, including structural and interpersonal racism, and its consequences for patient health (Chowkwanyun and Reed 2020; Ogendegbe 2020; Shah, Sachdeva, and Dodiuk-Gad 2020). Black and African American people, Indigenous people, and other people of color have endured disproportionately higher rates of COVID-19 cases and deaths during the pandemic. Thus, examining and addressing questions about differential health care treatment takes on heightened relevance and urgency. So, too, does understanding broader public health consequences. Research draws a connection between providers’ differential treatment and discrimination toward patients and patients’ distrust in medicine and medical science (Dean et al. 2017; Kennedy, Mathis, and Woods 2007; Suite et al. 2007). As such, how might experiencing past or current discrimination and unfair judgment when seeking health care affect a person’s trust in public health messages and guidance during the pandemic, including trust in the vaccines considered the best solution to end COVID-19’s dangerous effects (Latkin et al. 2021; Spalluto et al. 2020)? This brief is part of a body of work exploring perceptions of discriminatory experiences in health care and other settings (Gonzalez, Kenney, et al. 2021; Gonzalez, Skopec, et al. 2021; Pratt and Hahn 2021; Skopec, Gonzalez, and Kenney 2021). Here we present findings from follow-up interviews with 39 Black and African American nonelderly adults ages 18 to 64 who participated in the Urban Institute’s September 2020 Coronavirus Tracking Survey. In the survey, Black and African American adults reported discrimination or unfair judgment by a health care provider or their staff in the last 12 months at a share three times higher than that for white adults and two times higher than that for Hispanic/Latinx adults (Gonzalez, Skopec, et al. 2021). Because the survey did not probe deeply into these experiences, we designed our follow-up interviews to explore accounts of discrimination and unfair judgment and assess their consequences. Interviews took place between December 2020 and February 2021. We find the following: (1) The sample of adults commonly experienced unfair judgment by a doctor, health care provider, or their staff or knew someone who had. (a) Among the 39 people we interviewed, 22 reported personally experiencing discrimination or unfair judgment when seeking health care at some point in their lives. (b) Among the 17 people with no such personal experience, nearly half knew a family member or friend who had had such experiences. (2) Perceived discrimination and unfair judgment were rarely overt, and many people we interviewed could not discern whether their mistreatment was because of their race specifically or because of a combination of factors, including income, gender, health conditions, and disability. (3) Some people were more hesitant than others to label an experience as discrimination without clearer proof or evidence, yet they described encounters that health care research defines as likely discrimination. (4) Delayed treatment and critical misdiagnoses were notable negative consequences of perceived discrimination or unfair judgment by doctors, health care providers, or their staff. (5) Though most people planned to get a COVID-19 vaccine when it became available to them, most were hesitant about the decision. Those who had experienced perceived discrimination or unfair judgment were more hesitant about the vaccines than those who had not had such experiences.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-DC license. (More information)
- Extent:
- 1 online resource (1 PDF file (23 pages))
- NLM Unique ID:
- 9918300287106676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918300287106676