A recent study found an unexpectedly high level of discrimination against patients, researcher says.
More than 1 in 5 adults experience discrimination in healthcare settings, a recent research article found.
After lurking in the background for decades, health equity has emerged as a top concern in the U.S. healthcare system. In earlier research, experiences of discrimination in healthcare settings have been shown to drive negative impacts on trust, communication, and health-seeking behaviors.
The recent research article, which was published by JAMA Network Open, features survey data collected from more than 2,100 U.S. adults. The study includes several key data points.
- 458 (21.4%) of the survey respondents reported experiencing discrimination in healthcare settings
- Among survey respondents who reported experiencing discrimination, 72.0% reported experiencing discrimination in healthcare settings more than once
- Racial or ethnic discrimination was the most common type of reported discrimination (17.3%), followed by discrimination based on educational or income level (12.9%), weight (11.6%), and age (9.6%)
- The odds of experiencing discrimination were high for women (odds ratio 1.88)
- The odds of experiencing discrimination were low for older survey respondents (odds ratio 0.98), survey respondents earning at least $50,000 in annual household income (odds ratio 0.76), and survey respondents who reported good (odds ratio 0.59) or excellent (odds ratio 0.41) health compared to poor or fair health
- Non-Hispanic white survey respondents reported significantly less racial discrimination (4.0%) compared to non-Hispanic black survey respondents (54.6%) and Hispanic survey respondents (21.9%)
"The prevalence of discrimination identified in this study points to a need to examine discrimination in the healthcare system as a risk factor for other negative effects. Future work on interpersonal discrimination in the healthcare system should examine the types of discrimination we have identified herein, with the understanding that they are harms imposed on patients rather than caused by or reflective of patient demographic characteristics," the study's co-authors wrote.
Interpreting the data
The lead author of the study told HealthLeaders that the level of discrimination found in the research was higher than expected.
"The prevalence of discrimination in the healthcare system we identified (21.4%) was higher than we anticipated. Among those who reported discrimination, 72% experienced it more than once. We know that discrimination has serious downstream impacts on people's health and engagement with the health system, and we see this as an urgent issue," said Paige Nong, BA, a doctoral candidate in the Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan.
The study highlights the need to address discrimination against black patients, she said. "Because the study is national, we get a picture of the disproportionate impact of interpersonal racism on black people in the U.S. healthcare system. This adds to what we already know about the harms of racism in other domains such as housing, employment, and policing, for example. The discrimination we identify in our study is fundamentally a justice issue, reflecting both historical and contemporary racism."
The study also adds to the foundation of other research that should lead to effective interventions to address discrimination in healthcare settings, Nong said.
"We hope that our findings highlight this critical issue for healthcare systems and focus attention on the harm being done while people are seeking care. Although prior research analyzes interventions and ways to address discrimination more directly, we think that one part of addressing interpersonal discrimination effectively is more precise measurement and evidence-based responses. There is a wealth of important literature on discrimination that should necessarily inform these efforts. We think that our survey questions might be used to better understand the particular experiences of patients in healthcare systems across the country."
Related: AHA Announces Leadership Appointments to Expand Focus on Health Equity, Workforce
Christopher Cheney is the CMO editor at HealthLeaders.
KEY TAKEAWAYS
Among patients who had experienced discrimination, 72% said they had been subjected to discrimination more than once, a recent study found.
Racial or ethnic discrimination was the most common type of reported discrimination at 17.3% of patients, the study found.
Non-Hispanic white survey respondents reported significantly less racial discrimination (4.0%) compared to non-Hispanic black survey respondents (54.6%), the study found.