title: Correlates of patient-reported racial/ethnic health care discrimination in the Diabetes Study of Northern California (DISTANCE).
abstract: OBJECTIVE
  We examined possible determinants of self-reported health care discrimination.
  
  
  METHODS
  We examined survey data from the Diabetes Study of Northern California (DISTANCE), a race-stratified sample of Kaiser diabetes patients. Respondents reported perceived discrimination, and regression models examined socioeconomic, acculturative, and psychosocial correlates.
  
  
  RESULTS
  Subjects (n=17,795) included 20% Blacks, 23% Latinos, 13% East Asians, 11% Filipinos, and 27% Whites. Three percent and 20% reported health care and general discrimination. Health care discrimination was more frequently reported by minorities (ORs ranging from 2.0 to 2.9 compared with Whites) and those with poorer health literacy (OR=1.10, 95% CI: 1.04-1.16), limited English proficiency (OR=1.91, 95% CI: 1.32-2.78), and depression (OR=1.53, 95% CI: 1.10-2.13).
  
  
  CONCLUSIONS
  In addition to race/ethnicity, health literacy and English proficiency may be bases of discrimination. Evaluation is needed to determine whether patients are treated differently or more apt to perceive discrimination, and whether depression fosters and/or follows perceived discrimination.
authors.affiliation: University of Washington, Department of Health Services, School of Public Health, Seattle, WA 98195, USA. crees@u.washington.edu
authors.forename: Courtney R
authors.initials: CR
authors.lastname: Lyles
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Karter
authors.forename: Bessie A
authors.initials: BA
authors.lastname: Young
authors.forename: Clarence
authors.initials: C
authors.lastname: Spigner
authors.forename: David
authors.initials: D
authors.lastname: Grembowski
authors.forename: Dean
authors.initials: D
authors.lastname: Schillinger
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Adler
mesh_terms: D000368:Aged; D001213:Asian / Q000523:psychology* / Q000706:statistics & numerical data; D001294:Attitude to Health; D044383:Black People / Q000523:psychology* / Q000706:statistics & numerical data; D002140:California; D003144:Communication Barriers; D003863:Depression / Q000208:ethnology; D003920:Diabetes Mellitus / Q000208:ethnology*; D005202:Asia, Eastern / Q000208:ethnology; D005260:Female; D019538:Health Care Surveys; D057220:Health Literacy / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000208:ethnology*; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology / Q000706:statistics & numerical data; D010679:Philippines / Q000208:ethnology; D011287:Prejudice; D011369:Professional-Patient Relations; D012959:Socioeconomic Factors; D044465:White People / Q000523:psychology* / Q000706:statistics & numerical data; D001741:Black or African American