Perceived discrimination and use of preventive health services
- Amal N. TrivediAffiliated withDivision of General Medicine, Brigham and Women’s HospitalDepartment of Health Care Policy, Harvard Medical School
- , John Z. AyanianAffiliated withDivision of General Medicine, Brigham and Women’s HospitalDepartment of Health Care Policy, Harvard Medical School Email author
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BACKGROUND: Little is known about the relation between perceptions of health care discrimination and use of health services.
OBJECTIVES: To determine the prevalence of perceived discrimination in health care, its association with use of preventive services, and the contribution of perceived discrimination to disparities in these services by race/ethnicity, gender, and insurance status.
DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study of 54,968 respondents to the 2001 California Health Interview Survey.
MEASUREMENTS: Subjects were asked about experience with discrimination in receiving health care and use of 6 preventive health services, all within the previous 12 months.
METHODS: We used multivariate logistic regression with propensity-score methods to examine the adjusted relationship between perceived discrimination and receipt of preventive care.
RESULTS: Discrimination was reported by 4.7% of respondents, and among these respondents the most commonly reported reasons were related to type of insurance (27.6%), race or ethnicity (13.7%), and income (6.7%). In adjusted analyses, persons who reported discrimination were less likely to receive 4 preventive services (cholesterol testing for cardiovascular disease, hemoglobin A1c testing and eye exams for diabetes, and flu shots), but not 2 other services (aspirin for cardiovascular disease, prostate specific antigen testing). Adjusting for perceived discrimination did not significantly change the relative likelihood of receipt of preventive care by race/ethnieity, gender, and insurance status.
CONCLUSIONS: Persons who report discrimination may be less likely to receive some preventive health services. However, perceived discrimination is unlikely to account for a large portion of observed disparities in receipt of preventive care.
Key wordsdiscrimination disparities preventive care quality of care
- Perceived discrimination and use of preventive health services
Journal of General Internal Medicine
Volume 21, Issue 6 , pp 553-558
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- preventive care
- quality of care
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