Relationships between discrimination in health care and health care outcomes among four race/ethnic groups
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Discrimination has been found to be detrimental to health, but less is known about the influence of discrimination in health care. To address this, the current study (1) compared levels of racial/ethnic discrimination in health care among four race/ethnic groups; (2) determined associations between this type of discrimination and health care outcomes; and (3) assessed potential mediators and moderators as suggested by previous studies. Multivariate logistic regression models were used within a population-based sample of 1,699 White, African American, Mexican, and Puerto Rican respondents. Overall, 23 % of the sample reported discrimination in health care, with levels varying substantially by race/ethnicity. In adjusted models, this type of discrimination was associated with an increased likelihood of having unmet health care needs (OR = 2.48, CI = 1.57–3.90) and lower odds of perceiving excellent quality of care (OR = 0.43, CI = 0.28–0.66), but not with the use of a physician when not sick or use of alternative medicine. The mediating role of mental health factors was inconsistently observed and the relationships were not moderated by race/ethnicity. These findings expand the literature and provide preliminary evidence that can eventually inform the development of interventions and the training of health care providers.
KeywordsDiscrimination Racism Coping Race Ethnicity Health care utilization Quality of care CAM
The authors gratefully acknowledge the financial support of the American Cancer Society, IL Division (M. Benjamins, #183618). The Sinai Community Health Survey was completed with generous funding from The Robert Wood Johnson Foundation (#043026) and the Chicago Community Trust (#C2003-00844). We would also like to acknowledge the support of the Michael Reese Health Trust and the Frederick and Florence Roe Health Policy Fund. Finally, statistical advice from Sally Freels, Ph.D., was much appreciated. All mistakes are the authors own.
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