San Francisco Chronicle - (Sunday)

Survey: Minorities fear bias in health care

- By Colleen DeGuzman

Many people from racial and ethnic minority groups brace themselves for insults and judgments before medical appointmen­ts, according to a new survey of patients that reaffirms the prevalence of racial discrimina­tion in the U.S. health system.

The KFF survey of nearly 6,300 patients who have had care in the past three years found that about 55% of Black adults feel they have to be very careful about their appearance to be treated fairly by doctors and other health providers. Nearly half of American Indian, Alaska Native, and Hispanic patients feel similarly, as do about 4 in 10 Asian patients.

By comparison, 29% of white people surveyed said they worried about their appearance before appointmen­ts.

“In 2023, the notion that any person must prepare for discrimina­tion is sad on one hand and angering on the other,” Burgess Harrison, executive director of the National Minority Health Associatio­n, wrote in an email. “The stress that this causes, in addition to whatever health issue involved, is crazy.”

Discrimina­tion has long been a concern for both patients and health providers in the U.S., where racial disparitie­s in health outcomes are vast and particular­ly unfavorabl­e toward Black people.

A 30-year-old Hispanic man in Illinois who responded to the KFF survey told researcher­s he wears clothes to health care appointmen­ts with the logo of the university where he works. He noticed, he said, that when health care providers know he is a professor, they listen to him more intently and involve him more in care decisions.

A 44-year-old Asian woman in California told the researcher­s that her white male doctors ignored her concerns about breathing issues, telling her she “was probably just thinking too hard about breathing.” She was later diagnosed with asthma.

The two respondent­s were not identified in the study.

The survey offers “a way to actually quantify what those experience­s are with racism and discrimina­tion, and the multitude of ways they then impact people’s lives,” said Samantha Artiga, director of KFF’s racial equity and health policy program.

“For folks who have been following these issues for a long time, the findings are not unexpected,” she said.

Other findings:

Stephen Lam/The Chronicle

A third of adults reported at least one of several negative experience­s with a health care provider in the past three years, such as a profession­al assuming something about them without asking, or suggesting they were to blame for a health problem.

Nearly a quarter of Black adults, 19% of Alaska Native and Native American adults, 15% of

Yalonda M. James/The Chronicle

Hispanic adults, and 11% of Asian adults said they believed they endured negative treatment because of their race or ethnicity.

22% of Black adults who were pregnant or gave birth in the past 10 years said they were denied pain medication they thought they needed. 10% of white adults in similar circumstan­ces reported the same complaint.

When people don’t feel respected or welcomed by their health care providers, they may be discourage­d to reach out for medical help or may switch providers more often, Artiga said. Members of minority population­s are found to be “experienci­ng worse health as a result of experienci­ng unfair treatment in the health care system,” she said.

The survey also found that discrimina­tion outside the health care system had health consequenc­es. People who said they experience­d discrimina­tion in their everyday lives were more than twice as likely to report often feeling anxious, lonely, or depressed compared with those who rarely or never faced discrimina­tion.

Black people who self-reported darker skin tones were more likely to have encountere­d discrimina­tion than those with lighter skin, the survey found.

The survey reveals “how persistent and prevalent experience­s with racism and discrimina­tion remain today, in daily life and also in health care, despite, really, the increased calls and focus on addressing racism,” said Liz Hamel, KFF’s director of public opinion and survey research.

Diversity among health care providers matters, the survey found. Most people of color who participat­ed in the survey said that fewer than half of their medical visits in the past three years were with a provider who shared their race or ethnicity. But Black patients who had at least half their visits with a provider of their race or ethnicity, for example, were more likely to report better experience­s, such as their doctor explaining things “in a way they could understand” or asking them about health factors such as their employment, housing and access to food and transporta­tion.

Nearly 40% of Black adults whose health providers were also Black said they discussed such economic and social subjects, while just 24% of Black adults who saw providers who weren’t Black said those issues were brought up.

Harrison, of the National Minority Health Associatio­n, wrote that “a renewed emphasis on recruiting more people of color into the health care field is vital.”

The survey, he added, “painfully illustrate­s that racial bias in healthcare is as damaging as any disease.”

KFF’s “Survey on Racism, Discrimina­tion and Health” was conducted from June 6 to Aug. 14 online and by telephone among a nationally representa­tive sample of U.S. adults in English, Spanish, Chinese, Korean, and Vietnamese.

Colleen DeGuzman reports on a broad range of public health topics for KFF Health News, formerly known as Kaiser Health News, a national newsroom that produces in-depth journalism about health issues. Follow her on X @acolleendg.

LiPo Ching/ Special to The Chronicle 2020

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 ?? ?? Dr. Kim Rhoads, center, talks with Seana McGee during a fair at Hayes Valley Playground. Rhoads started Umoja Health to fill voids in health care the Black community was facing.
Dr. Kim Rhoads, center, talks with Seana McGee during a fair at Hayes Valley Playground. Rhoads started Umoja Health to fill voids in health care the Black community was facing.
 ?? ?? Elizabeth Worthingto­n receives a flu vaccine. A survey found people of color expect racial discrimina­tion in medical care.
Elizabeth Worthingto­n receives a flu vaccine. A survey found people of color expect racial discrimina­tion in medical care.
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