Leslie R M Hausmann1, Nancy R Kressin, Barbara H Hanusa, Said A Ibrahim. 1. Health Services Research & Development Service, Veterans Affairs Pittsburgh Healthcare System, Center for Health Equity Research and Promotion, Pittsburgh, PA 15206, USA. leslie.hausmann@gmail.com
Abstract
OBJECTIVES: Examine whether three measures of perceived racial discrimination in health care detect similar rates of discrimination and show similar associations with patients' healthcare experiences. DESIGN: Cross-sectional observational study involving telephone surveys and medical record reviews. SETTING: Veterans Affairs Pittsburgh Healthcare System. PARTICIPANTS: 50 White and 50 African American veterans with diabetes. MAIN OUTCOME MEASURES: Three types of measures of perceived racial discrimination in health care were compared: single-item and multi-item measures assessing personal experiences of discrimination in healthcare settings, and a measure assessing general racism in the healthcare system. Associations of each measure with patient-reported problems with their medical care and receipt of recommended preventive screenings were also explored. RESULTS: More African American than White veterans reported perceived discrimination on all measures (personal discrimination, single-item: 42% vs 6%, P<.001; personal discrimination, multi-item: 42% vs 18%, P=.01; general racism: 74% vs 40%, P=.001). In the total sample, discrimination was more likely to be reported on the general racism measure than on the single-item (OR=36.53, 95% CI=7.95-167.89) or multi-item measures (OR=20.28, 95% CI=5.12-80.34) of personal discrimination. The multi-item measure of personal discrimination (OR=3.96, 95% CI=1.29-12.18) and general racism measure (OR=3.61, 95% CI=1.34-9.71) were significantly associated with patient-reported problems with their care. Receipt of recommended screenings was not associated with any of the discrimination measures. CONCLUSIONS: Different measures of perceived racial discrimination in healthcare settings yield different rates of discrimination and show variable associations with patients' perceptions of care.
OBJECTIVES: Examine whether three measures of perceived racial discrimination in health care detect similar rates of discrimination and show similar associations with patients' healthcare experiences. DESIGN: Cross-sectional observational study involving telephone surveys and medical record reviews. SETTING: Veterans Affairs Pittsburgh Healthcare System. PARTICIPANTS: 50 White and 50 African American veterans with diabetes. MAIN OUTCOME MEASURES: Three types of measures of perceived racial discrimination in health care were compared: single-item and multi-item measures assessing personal experiences of discrimination in healthcare settings, and a measure assessing general racism in the healthcare system. Associations of each measure with patient-reported problems with their medical care and receipt of recommended preventive screenings were also explored. RESULTS: More African American than White veterans reported perceived discrimination on all measures (personal discrimination, single-item: 42% vs 6%, P<.001; personal discrimination, multi-item: 42% vs 18%, P=.01; general racism: 74% vs 40%, P=.001). In the total sample, discrimination was more likely to be reported on the general racism measure than on the single-item (OR=36.53, 95% CI=7.95-167.89) or multi-item measures (OR=20.28, 95% CI=5.12-80.34) of personal discrimination. The multi-item measure of personal discrimination (OR=3.96, 95% CI=1.29-12.18) and general racism measure (OR=3.61, 95% CI=1.34-9.71) were significantly associated with patient-reported problems with their care. Receipt of recommended screenings was not associated with any of the discrimination measures. CONCLUSIONS: Different measures of perceived racial discrimination in healthcare settings yield different rates of discrimination and show variable associations with patients' perceptions of care.
Authors: Ricci Harris; Donna Cormack; Martin Tobias; Li-Chia Yeh; Natalie Talamaivao; Joanna Minster; Roimata Timutimu Journal: Am J Public Health Date: 2012-03-15 Impact factor: 9.308
Authors: Serena MacDonald; Leslie R M Hausmann; Florentina E Sileanu; Xinhua Zhao; Maria K Mor; Sonya Borrero Journal: Med Care Date: 2017-09 Impact factor: 2.983
Authors: Serena MacDonald; Colleen Judge-Golden; Sonya Borrero; Xinhua Zhao; Maria K Mor; Leslie R M Hausmann Journal: Med Care Date: 2020-05 Impact factor: 2.983
Authors: Wendy S Looman; Megan Antolick; Rhonda G Cady; Scott A Lunos; Ann E Garwick; Stanley M Finkelstein Journal: J Pediatr Health Care Date: 2015-03-05 Impact factor: 1.812