title: Perceived Discrimination and Privilege in Health Care: The Role of Socioeconomic Status and Race.
abstract: BACKGROUND
  This study examined how perceived racial privilege and perceived racial discrimination in health care varied with race and socioeconomic status (SES).
  
  
  METHODS
  The sample consisted of white, black, and Native American respondents to the Behavioral Risk Factor Surveillance System (2005-2013) who had sought health care in the past 12 months. Multiple logistic regression models of perceived racial privilege and perceived discrimination were estimated. Analyses were performed in 2016.
  
  
  RESULTS
  Perceptions of racial privilege were less common among blacks and Native Americans compared with whites, while perceptions of racial discrimination were more common among these minorities. In whites, higher income and education contributed to increased perceptions of privileged treatment and decreased perceptions of discrimination. The pattern was reversed in blacks, who reported more discrimination and less privilege at higher income and education levels. Across racial groups, respondents who reported foregone medical care due to cost had higher risk of perceived racial discrimination. Health insurance contributed to less perceived racial discrimination and more perceived privilege only among whites.
  
  
  CONCLUSIONS
  SES is an important social determinant of perceived privilege and perceived discrimination in health care, but its role varies by indicator and racial group. Whites with low education or no health insurance, well-educated blacks, and individuals who face cost-related barriers to care are at increased risk of perceived discrimination. Policies and interventions to reduce these perceptions should target structural and systemic factors, including society-wide inequalities in income, education, and healthcare access, and should be tailored to account for racially specific healthcare experiences.
authors.affiliation: Department of Sociology, University of Alabama at Birmingham, Birmingham, Alabama; Research Centre for Toxic Compounds in the Environment, Masaryk University, Brno, Czech Republic;. Electronic address: irena@uab.edu.
authors.forename: Irena
authors.initials: I
authors.lastname: Stepanikova
authors.affiliation: Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Gabriela R
authors.initials: GR
authors.lastname: Oates
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D040343:Behavioral Risk Factor Surveillance System; D003430:Cross-Sectional Studies; D004192:Discrimination, Psychological; D005260:Female; D006297:Health Services Accessibility / Q000941:ethics / Q000706:statistics & numerical data; D006304:Health Status; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007198:Indians, North American / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology / Q000706:statistics & numerical data; D010465:Perception; D063505:Racism / Q000523:psychology / Q000706:statistics & numerical data*; D012923:Social Class; D014481:United States / Q000208:ethnology; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult