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Primary Submission Category: Health equity

Everyday and Healthcare Discrimination at the Intersection of Age, Gender, Race, Ethnicity, and Sexual Orientation

Authors:  Delvon T. Mattingly, Meman Diaby, Luis Zavala Arciniega, Carrie B. Oser, Shyanika W. Rose,

Presenting Author: Delvon Mattingly*

Background: Discrimination is characterized as unfair or unjust mistreatment based on perceived or observed social identity or phenotypical traits. We used a visualization tool to display a detailed characterization of the prevalence of everyday and healthcare discrimination at the intersection of age, gender, race, ethnicity, and sexual orientation.

Methods: We used imputed data from the All of Us Research Program (version 7) on adults aged 18+ years (n=117,688) to estimate the prevalence of the continuous Everyday Discrimination Scale (EDS) (range: 0-5) and Healthcare Discrimination Scale (HDS) (range: 0-4). We calculated mean discrimination estimates for the EDS and HDS for each possible combination of age (18-29, 30-49, 50+ years), gender (male, female), race and ethnicity (Hispanic, non-Hispanic [NH] White, NH Black, NH multiracial, NH Asian), and sexual orientation (heterosexual, LGB+), and compared across mean estimates using ANOVA.

Results: The mean EDS and HDS were 0.80 and 0.57. Groups with the highest levels of EDS were NH Black LGB+ men aged 18-29 years (mean: 2.07, 95% CI: 1.80-2.34) and NH multiracial LGB+ women aged 30-49 years (mean: 1.73, 95% CI: 1.64-1.81). Groups with the lowest levels were NH White heterosexual men aged 50+ years (mean: 0.56, 95% CI: 0.55-0.56) and NH White heterosexual women aged 50+ years (mean: 0.61, 95% CI: 0.61-0.62). Groups with the highest levels of HDS were NH Black heterosexual women aged 18-29 years (mean: 1.46, 95% CI: 1.40-1.51) and NH Asian heterosexual women aged 18-29 years (mean: 1.22, 95% CI: 1.19-1.26). Groups with the lowest levels were NH multiracial heterosexual men aged 18-29 years (mean: 0.37, 95% CI: 0.32-0.43) and NH White heterosexual men aged 50+ years (mean: 0.43, 95% CI: 0.42-0.43).

Conclusions: Our findings highlight specific groups most and least at risk of experiencing mistreatment in their daily lives and healthcare settings, informing existing public health policy and prevention efforts.