Healthcare Stereotype Threat in Older Adults in the Health and Retirement Study.
BACKGROUND
Healthcare stereotype threat is the threat of being personally reduced to group stereotypes that commonly operate within the healthcare domain, including stereotypes regarding unhealthy lifestyles and inferior intelligence. The objective of this study was to assess the extent to which people fear being judged in healthcare contexts on several characteristics, including race/ethnicity and age, and to test predictions that experience of such threats would be connected with poorer health and negative perceptions of health care.


METHODS
Data were collected as part of the 2012 Health and Retirement Study (HRS). A module on healthcare stereotype threat, designed by the research team, was administered to a random subset (n=2,048 of the total 20,555) of HRS participants. The final sample for the present healthcare stereotype threat experiment consists of 1,479 individuals. Logistic regression was used to test whether healthcare stereotype threat was associated with self-rated health, reported hypertension, and depressive symptoms, as well as with healthcare-related outcomes, including physician distrust, dissatisfaction with health care, and preventative care use.


RESULTS
Seventeen percent of respondents reported healthcare stereotype threat with respect to one or more aspects of their identities. As predicted, healthcare stereotype threat was associated with higher physician distrust and dissatisfaction with health care, poorer mental and physical health (i.e., self-rated health, hypertension, and depressive symptoms), and lower odds of receiving the influenza vaccine.


CONCLUSIONS
The first of its kind, this study demonstrates that people can experience healthcare stereotype threat on the basis of various stigmatized aspects of social identity, and that these experiences can be linked with larger health and healthcare-related outcomes, thereby contributing to disparities among minority groups.
Davis School of Gerontology and Department of Psychology, University of Southern California, Los Angeles, California. Electronic address: cabdou@usc.edu.
Cleopatra M
CM
Abdou
Department of Psychology, Loyola Marymount University, Los Angeles, California.
Adam W
AW
Fingerhut
Institute for Social Research, Department of Psychology, and School of Public Health, University of Michigan, Ann Arbor, Michigan;
James S
JS
Jackson
Davis School of Gerontology, University of Southern California, Los Angeles, California.
Felicia
F
Wheaton
D000367:Age Factors; D000368:Aged; D063506:Ageism / Q000523:psychology; D001291:Attitude of Health Personnel; D003863:Depression / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000523:psychology; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D050177:Overweight / Q000523:psychology; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D011287:Prejudice / Q000523:psychology*; D063505:Racism / Q000523:psychology; D012737:Sex Factors; D012959:Socioeconomic Factors; D013240:Stereotyping