New research has found more than one in five adults say they experienced discrimination when receiving healthcare, with such occurrences more common among racial and ethnic minorities, lower income, and less healthy patients.
Racial discrimination was the most common type reported among patients included in a study published Tuesday in JAMA Network Open.
A higher proportion of Black and Brown patients, as well as adults with other non-white racial and ethnic identities, reported experiencing discrimination in their interpersonal encounters with healthcare staff compared to white respondents.
Previous studies have estimated between 7% and 14%of patients had experienced discrimination while in a healthcare setting.
Study co-author Paige Nong, a doctoral student of sociology and organizational studies at the University of Michigan’s School of Public Health, said the latest findings provide stakeholders with a better sense of the impact that interpersonal racism occurrences have on patient experiences.
“Awareness of the prevalence of discrimination is critical so they can work to prevent discrimination in healthcare settings,” Nong said. “Collecting data on the types of discrimination occurring in their own systems will help them build evidence-based approaches to stopping discrimination against patients.”
Healthcare providers have become more interested in addressing healthcare discrimination and health inequality this year, as they respond to protests across the country following the death of George Floyd and the disproportionate impact the COVID-19 pandemic has had on communities of color.
Interpersonal discrimination in healthcare can have far-reaching implications and create barriers to building trust between providers and minority communities, Nong said. That trust will be necessary in the coming months as providers encourage Americans to get vaccinated against COVID-19.
“We hope our analysis can contribute one piece of the puzzle and help us consider systemic barriers the health system may be posing to patients who need care, rather than blaming patients whose experiences have threatened their trust in the system for hesitation or concern,” Nong said.
More than 2,100 adults were surveyed for the study, which sought to measure the demographics and health-related characteristics of patients who reported experiencing discrimination when receiving care and the primary types of discrimination they experienced. In addition to race, the most commonly reported types of discrimination identified were based on a patient’s level of education or income level, as well as their weight, gender and age.
Of the 458 patients who reported experiencing discrimination, 63% were women and 60% were adults who had household incomes of less than $50,000 a year. Previous studies have shown women and lower-income adults have healthcare disparities in access and quality that can lead to poorer health outcomes.
Nong said healthcare providers should collect information on patient experiences with discrimination to help inform them on making the kinds of the policy changes that address inequity. Such information can also help hospitals to identify where patients may be experiencing other types of discrimination, such as issues involving a patient’s substance use disorder or insurance status.
“Although the discrimination we analyze here is interpersonal, these experiences also take place in the context of systemic inequity,” Nong said. “Combining all of the knowledge we have about systemic inequities with this information about interpersonal discrimination will hopefully help us appreciate the many ways inequity operates.”