1 in 5 older patients felt discriminated against by doctors, hospitals

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 - Thu Nguyen, ScD, MSPH
Thu Nguyen, ScD, MSPH

Racial discrimination was by far the most common reason cited by black patients for receiving poor service or treatment from physicians or hospitals, according to a study published in the Journal of General Internal Medicine. White and Hispanic patients, however, also reported “high rates of discrimination” for other reasons such as age, weight or income.

Researchers from UC Berkeley, UC San Francisco and Stanford University analyzed responses from nearly 14,000 patients aged 54 and older participating in the University of Michigan’s Health and Retirement Study between 2008 and 2014. The patients’ conditions included hypertension, diabetes, cancer, lung disease, heart disease and stroke.

The percentage of black patients who reported experiencing discrimination in healthcare settings declined over that period, dropping from 27 percent to 20 percent. The most common reason cited for discrimination in 2008 among black patients was race (48 percent), followed by age (29 percent) and financial status (20 percent). For black patients, the predicted probability for reporting any discrimination didn’t decline among wealthier patients as did it for white and Hispanic patients.

“If people believe they have received unfair treatment in the healthcare setting, that experience could negatively affect their experience with their providers, their willingness to go to their providers, and their adherence with their treatment, and thereby affect their health,” said study author Thu Nguyen, ScD, MSPH, a UCSF researcher. “It’s still very common, and there’s a long way to go.”

For Hispanic patients, researchers didn’t see a clear trend on reporting discrimination over the study period. In 2008, they reported experiencing discrimination at a lower rate than white patients, edging up slightly in 2010, then falling back to its original level by 2014. The types of discrimination that Hispanics reported most often in 2008 were age (27 percent), race or ancestry (23 percent), weight/physical appearance (14 percent), and financial status (14 percent).

For white patients, the percentage reporting experiencing discrimination hovered around 17 percent throughout the study period. Their reported discrimination most commonly involved age (29 percent) weight/physical appearance characteristic (16 percent), gender (10 percent) and financial status (10 percent).

“The current study indicates that reports of discrimination in the healthcare setting remain common,” Nguyen and her coauthors wrote. “Continual monitoring of trends is important in order to track changes in reports of discrimination and to determine whether reported discrimination among Blacks continues to decline. Additionally, simply recognizing how common these experiences are for patients may help clinicians provide more appropriate, patient-centered care. Ongoing efforts are needed to eliminate discrimination and to monitor progress toward achieving equity in clinical interactions.”