Perceived discrimination in U.S. healthcare: Charting the effects of key social characteristics within and across racial groups.
Perceived discrimination in U.S. healthcare: Charting the effects of key social characteristics within and across racial groups.
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DOI：
10.1016/j.pmedr.2015.07.006
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发表时间：
2015-01-01
影响因子：
2.8
通讯作者：
Sanchez-Jankowski, Martin
中科院分区：
文献类型：
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作者：
Abramson, Corey M;Hashemi, Manata;Sanchez-Jankowski, Martin
本文采用了原始的实证分析，以促进科学的理解之间的关系的社会特征和感知的歧视，在医疗保健遇到的种族类别内和跨在美国我们的分析集中在一个不同的样本43,020名成年人，年龄在18至85岁，从加州健康访谈调查（CHIS）。我们使用一系列加权描述性统计和逻辑回归模型来解析与感知歧视相关的因素，并绘制它们如何随种族和民族而变化的图表。少数种族的成员更有可能报告歧视的看法，虽然通过将患者和医疗保健系统因素引入我们的模型，这种影响在一定程度上有所减轻，但种族影响仍然具有统计学意义和相当大的幅度（特别是对非洲裔美国人和美洲原住民）。自我报告的健康状况不佳和沟通困难的临床遭遇与所有群体的歧视增加的看法。此外，在非白人中，教育程度的提高与其他因素的歧视感增加有关。这些研究结果表明，减少医疗保健差距的努力应继续侧重于扩大弱势种族群体的患者-提供者互动的深度和质量，同时还应注意影响种族群体内和种族群体之间医疗保健遭遇中种族歧视的其他因素。
This article employs an original empirical analysis to contribute to scientific understandings of the relationship between social characteristics and perceptions of discrimination in healthcare encounters within and across racial categories in the U.S. Our analysis focuses on a diverse sample of 43,020 adults aged 18 to 85 drawn from the California Health Interview Survey (CHIS). We use a series of weighted descriptive statistics and logistic regression models to parse out factors associated with perceived discrimination and chart how they vary by race and ethnicity. Members of racial minorities were more likely to report perceptions of discrimination, and while the effect was somewhat mitigated by introducing patient and health-care system factors into our models, the race effects remained both statistically significant and of substantial magnitude (particularly for African Americans and Native Americans). Poor self-reported health and communication difficulties in the clinical encounter were associated with increased perceptions of discrimination across all groups. Further, among non-whites, increased education was associated with increased perceptions of discrimination net of other factors. These findings suggest efforts to reduce disparities in medical care should continue to focus on expanding the depth and quality of patient-provider interactions for disadvantaged racial groups, while also being attentive to other factors that affect perceived racial discrimination in healthcare encounters within and across racial groups.