Ayesha Azeem ‘23
Doctors take an oath to treat all patients, regardless of their identity, equally. Unfortunately, this oath is often broken. While this may not be intentional, it still affects a large number of people who put their faith in the healthcare system. Psychologists have attributed this phenomenon to implicit bias, or our subconscious beliefs about other people, which can affect the way healthcare providers treat their patients. Unfortunately, the adverse experience many individuals have faced in the healthcare field has led to unsatisfactory and often minimal use of health care. A study led by Héctor E. Alcalá, PhD, sought to investigate how discrimination places a role in health care utilization.
Dr. Alcalá mainly studied whether the type of health insurance coverage and location of health care facilities had a relationship with perceptions of racial discrimination in health care. He further assessed whether discrimination influenced future health care visits, and whether seeking care was delayed by patients. The 2015-2016 California Health Interview Survey was used to assess this, and the research team reviewed responses from over 39,000 adults aged 18 or over. The main variables assessed included: current insurance coverage, location of source of medical care, delay or abandonment of medical care, and delay or abandonment of prescriptions. The team then investigated whether these factors were influenced by race.
The research team found that when assessing insurance type and location of care, only the type of insurance coverage was associated with perceived racial discrimination. Individuals with Medicaid experienced a 66% increased chance of perceiving discrimination, in comparison to individuals with employer-sponsered insurance. Race did not change the impact of discrimination. When individuals perceive racial discrimination, they tend to delay or abandon both their prescriptions as well as seeking future medical care.
This study indicates the obvious negligence in the healthcare field with regards to racial discrimination and patient avoidance. Healthcare providers as well as policymakers should ensure that equal and equitable medical care is provided to everyone, and that implicit bias in the workplace should be minimized as much as possible. Racial discrimination can have lasting health effects on patients, as they may refuse to seek future medical care, leading to dire physical and mental health consequences.
 H.E. Alcalá, D.M. Cook, Racial discrimination in health care and utilization of health care: A cross-sectional study of California adults. J Gen Intern Med 33, 1760-1767 (2018). doi: 10.1007/s11606-018-4614-4.
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