nach oben

Erschienen in:

01.07.2009 | Original Article

Association Between Prior Experiences of Discrimination and Patients’ Attitudes Towards Health Care Providers Collecting Information About Race and Ethnicity

verfasst von: Namratha R. Kandula, MD, MPH, Romana Hasnain-Wynia, PhD, Jason A. Thompson, BA, E. Richard Brown, PhD, David W. Baker, MD MPH

Erschienen in: Journal of General Internal Medicine | Ausgabe 7/2009

Einloggen, um Zugang zu erhalten

Abstract

BACKGROUND

Previously, we reported a high level of comfort among Californians for collecting race/ethnicity information by health care providers (HCPs). However, minorities were less comfortable providing race/ethnicity information and were more worried than non-Hispanic whites about the potential misuse of this information.

OBJECTIVE

To determine if perceived experiences of discrimination (both in general and in medical care) were associated with comfort providing race/ethnicity information, and conversely, to worry about providing the information.

DESIGN AND PARTICIPANTS

Telephone survey of 480 Californians, including 101 whites, 98 Asians, 173 Hispanics, 82 blacks, and 26 multiracial individuals.

MEASUREMENTS

Comfort level giving HCPs information about race/ethnicity (measured on a 1–10 scale, with text anchors of “very uncomfortable” at 1 and “very comfortable” at 10), worry that the information could be used to discriminate against patients, and worry that the information could be used to find undocumented immigrants. Worry was measured using a four-point Likert scale- not worried at all, a little worried, somewhat worried, and very worried. Respondents were also asked about perceived discrimination in general and perceived discrimination in medical care.

RESULTS

Compared to whites, Hispanics (Beta-coefficient (BC) = -1.16, SE = 0.51) and Mandarin/Cantonese-speaking Asians (BC = -1.40, SE = 0.65) reported significantly less comfort giving HCPs information about their race/ethnicity, while blacks (BC = 0.70, SE = 0.16), Hispanics (BC = 0.91, SE = 0.18), and multiracial individuals (BC = 0.63, SE = 0.24) were significantly more worried that race/ethnicity information could be used to discriminate against them. Adjusting for perceived experiences of discrimination in general and in medical care partially explained the higher discomfort and worry among minorities.

CONCLUSIONS

Perceived experiences of discrimination are associated with greater discomfort and worry about providing race/ethnicity data. Health care institutions should consider how they can address the public’s concerns about possible misuses of data.

Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care: Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, 2003; Washington, D.C.

Friedman DJ, Cohen BB, Averbach AR, Norton JM. Race/ethnicity and OMB Directive 15: implications for state public health practice. Am J Public Health. 2000;90(11):1714–9.PubMedCrossRef

Hasnain-Wynia R, Baker DW. Obtaining data on patient race, ethnicity, and primary language in health care organizations: current challenges and proposed solutions. Health Serv Res. 2006;41(4 Pt 1):1501–18.PubMed

Panel on DHHS Collection of Race and Ethnicity Data. Eliminating Health Disparities: Measurement and Data Needs. Washington, D.C.: National Academies Press; 2004.

Baker DW, Cameron KA, Feinglass J, et al. Patients’ attitudes toward health care providers collecting information about their race and ethnicity. J Gen Intern Med. 2005;20(10):895–900.PubMedCrossRef

Baker DW, Hasnain-Wynia R, Kandula NR, Thompson JA, Brown ER. Attitudes toward health care providers, collecting information about patients’ race, ethnicity, and language. Med Care. 2007;45(11):1034–42.PubMedCrossRef

Bird ST, Bogart LM. Perceived race-based and socioeconomic status(SES)-based discrimination in interactions with health care providers. Ethn Dis. 2001;11(3):554–63.PubMed

Johnson RL, Saha S, Arbelaez JJ, Beach MC, Cooper LA. Racial and ethnic differences in patient perceptions of bias and cultural competence in health care. J Gen Intern Med. 2004;19(2):101–10.PubMedCrossRef

Lauderdale DS, Wen M, Jacobs EA, Kandula NR. Immigrant perceptions of discrimination in health care: the California Health Interview Survey 2003. Med Care. 2006;44(10):914–20.PubMedCrossRef

10.

Blanchard J, Lurie N. R-E-S-P-E-C-T: patient reports of disrespect in the health care setting and its impact on care. J Fam Pract. 2004;53(9):721–30.PubMed

11.

Adegbembo AO, Tomar SL, Logan HL. Perception of racism explains the difference between Blacks’ and Whites’ level of healthcare trust. Ethn Dis. 2006;16(4):792–8.PubMed

12.

U.S. Census Bureau. California – Ability to Speak English by Language Spoken at Home for the Population 5 Years and Over: 2000. Available at http://www.census.gov/population/cen2000/phc-t37/tab06a.xls. Last Accessed April 7, 2009.

13.

American Association of Public Opinion Research. Response Rate Calculator. Available at http://www.aapor.org/uploads/Response_Rate_Calculator.xls. Last accessed April 7, 2009.

14.

Boulware LE, Cooper LA, Ratner LE, LaVeist TA, Powe NR. Race and trust in the health care system. Public Health Rep. 2003;118(4):358–65.PubMed

15.

Halbert CH, Armstrong K, Gandy OH Jr., Shaker L. Racial differences in trust in health care providers. Arch Intern Med. 2006;166(8):896–901.PubMedCrossRef

16.

Mainous AG 3rd, Smith DW, Geesey ME, Tilley BC. Development of a measure to assess patient trust in medical researchers. Ann Fam Med. 2006;4(3):247–52.PubMedCrossRef

17.

Stepanikova I, Mollborn S, Cook KS, Thom DH, Kramer RM. Patients’ race, ethnicity, language, and trust in a physician. J Health Soc Behav. 2006;47(4):390–405.PubMedCrossRef

18.

LaVeist TA, Nickerson KJ, Bowie JV. Attitudes about racism, medical mistrust, and satisfaction with care among African American and white cardiac patients. Med Care Res Rev. 2000;57(Suppl 1):146–61.PubMed

Titel: Association Between Prior Experiences of Discrimination and Patients’ Attitudes Towards Health Care Providers Collecting Information About Race and Ethnicity
verfasst von: Namratha R. Kandula, MD, MPH
Romana Hasnain-Wynia, PhD
Jason A. Thompson, BA
E. Richard Brown, PhD
David W. Baker, MD MPH
Publikationsdatum: 01.07.2009
Verlag: Springer-Verlag
Erschienen in: Journal of General Internal Medicine / Ausgabe 7/2009
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-009-0991-z

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Reizdarmsyndrom: Diäten wirksamer als Medikamente

29.04.2024 Reizdarmsyndrom Nachrichten

Bei Reizdarmsyndrom scheinen Diäten, wie etwa die FODMAP-arme oder die kohlenhydratreduzierte Ernährung, effektiver als eine medikamentöse Therapie zu sein. Das hat eine Studie aus Schweden ergeben, die die drei Therapieoptionen im direkten Vergleich analysierte.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

BACKGROUND

OBJECTIVE

DESIGN AND PARTICIPANTS

MEASUREMENTS

RESULTS

CONCLUSIONS

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 7/2009

A Sore Throat—Potentially Life-Threatening?

Retrospective Analysis of Diabetes Care in California Medicaid Patients with Mental Illness

Filling the Gap: The Importance of Medicaid Continuity for Former Inmates

The Risks of Rewards in Health Care: How Pay-for-performance Could Threaten, or Bolster, Medical Professionalism

High Quality Care and Ethical Pay-for-Performance: A Society of General Internal Medicine Policy Analysis

Primary Care Physicians Treat Somatization