Primary Submission Category: Health care/services
Perceived Discrimination in a Healthcare Setting among U.S. Black Middle-Aged and Older Adults
Authors: Michael Green Heather Farmer Cassie Ford Hanzhang Xu Matthew Dupre
Presenting Author: Michael Green*
In the United States, Black adults report experiencing daily discrimination at higher rates than White adults, the most commonly used comparison group for racial disparities. The association between perceived everyday discrimination and various health outcomes has been studied extensively for decades. However, our understanding of the factors associated with perceived discrimination in healthcare settings for Black adults in later life remain largely unknown at the national level. Our study used data from participant baseline observations in the Health and Retirement Study, spanning from 2008 to 2018. The objective of the study was to examine the demographic, socioeconomic, psychosocial, behavioral, and physiological factors associated with experiencing discrimination in a healthcare setting among non-Hispanic Black adults aged 50+ (n=3,033). Discrimination in a healthcare setting was derived from an item in the Perceived Everyday Discrimination scale that asked respondents how often they received poorer service or treatment from doctors or hospitals compared to others. Participants were grouped into those who reported never experiencing discrimination (76.8%) and those who reported ever experiencing discrimination (23.2%). Results from multivariable logistic models of baseline observations showed that age (OR=0.97; p<0.001), being male (OR=1.27; p=0.019), more education (OR=1.04; p=0.020), depressive symptoms (OR=1.13; p<0.001), functional limitations (OR=1.30; p=0.006), prior stroke (OR=0.67; p=0.019), and number of doctor visits (OR=1.02; p=0.002) were significantly associated with reporting discrimination in healthcare. Overall, we find that a wide array of demographic, socioeconomic, psychosocial, and physiological factors were associated with experiencing discrimination in a healthcare setting among Black middle-aged and older adults. Future research is needed to examine potential health consequences of unequal treatment in clinical encounters.