Journal of General Internal Medicine

, Volume 21, Issue 6, pp 553–558

Perceived discrimination and use of preventive health services

Original Articles

DOI: 10.1111/j.1525-1497.2006.00413.x

Cite this article as:
Trivedi, A.N. & Ayanian, J.Z. J Gen Intern Med (2006) 21: 553. doi:10.1111/j.1525-1497.2006.00413.x


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 words

discriminationdisparitiespreventive carequality of care

Copyright information

© Society of General Internal Medicine 2006

Authors and Affiliations

  1. 1.Division of General MedicineBrigham and Women’s HospitalBostonUSA
  2. 2.Department of Health Care PolicyHarvard Medical SchoolBostonUSA