title: Relationships between discrimination in health care and health care outcomes among four race/ethnic groups.
abstract: Discrimination has been found to be detrimental to health, but less is known about the influence of discrimination in health care. To address this, the current study (1) compared levels of racial/ethnic discrimination in health care among four race/ethnic groups; (2) determined associations between this type of discrimination and health care outcomes; and (3) assessed potential mediators and moderators as suggested by previous studies. Multivariate logistic regression models were used within a population-based sample of 1,699 White, African American, Mexican, and Puerto Rican respondents. Overall, 23% of the sample reported discrimination in health care, with levels varying substantially by race/ethnicity. In adjusted models, this type of discrimination was associated with an increased likelihood of having unmet health care needs (OR = 2.48, CI = 1.57-3.90) and lower odds of perceiving excellent quality of care (OR = 0.43, CI = 0.28-0.66), but not with the use of a physician when not sick or use of alternative medicine. The mediating role of mental health factors was inconsistently observed and the relationships were not moderated by race/ethnicity. These findings expand the literature and provide preliminary evidence that can eventually inform the development of interventions and the training of health care providers.
authors: Sinai Urban Health Institute, Mt. Sinai Hospital, 1500 S. California Ave, Chicago, IL, 60608, USA, maureen.benjamins@sinai.org.
authors: Maureen R
authors: MR
authors: Benjamins
authors: Steven
authors: S
authors: Whitman
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data*; D000368:Aged; D005006:Ethnicity; D005260:Female; D006296:Health Services / Q000592:standards / Q000706:statistics & numerical data; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017058:Mexican Americans / Q000523:psychology / Q000706:statistics & numerical data; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011647:Puerto Rico / Q000208:ethnology; D044469:Racial Groups; D063505:Racism / Q000523:psychology / Q000706:statistics & numerical data*; D014481:United States / Q000208:ethnology; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult