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Perceived discrimination and use of preventive health services

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Abstract

BACKGROUND: Little is known about the relation between perceptions of health care discrimination and use of health services.

OBJECTIVES: To determine the prevalence of perceived discrimination in health care, its association with use of preventive services, and the contribution of perceived discrimination to disparities in these services by race/ethnicity, gender, and insurance status.

DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study of 54,968 respondents to the 2001 California Health Interview Survey.

MEASUREMENTS: Subjects were asked about experience with discrimination in receiving health care and use of 6 preventive health services, all within the previous 12 months.

METHODS: We used multivariate logistic regression with propensity-score methods to examine the adjusted relationship between perceived discrimination and receipt of preventive care.

RESULTS: Discrimination was reported by 4.7% of respondents, and among these respondents the most commonly reported reasons were related to type of insurance (27.6%), race or ethnicity (13.7%), and income (6.7%). In adjusted analyses, persons who reported discrimination were less likely to receive 4 preventive services (cholesterol testing for cardiovascular disease, hemoglobin A1c testing and eye exams for diabetes, and flu shots), but not 2 other services (aspirin for cardiovascular disease, prostate specific antigen testing). Adjusting for perceived discrimination did not significantly change the relative likelihood of receipt of preventive care by race/ethnieity, gender, and insurance status.

CONCLUSIONS: Persons who report discrimination may be less likely to receive some preventive health services. However, perceived discrimination is unlikely to account for a large portion of observed disparities in receipt of preventive care.

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Author information

Authors and Affiliations

  1. Division of General Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Amal N. Trivedi MD, MPH &  John Z. Ayanian MD, MPP

  2. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA

    Amal N. Trivedi MD, MPH &  John Z. Ayanian MD, MPP

Authors
  1. Amal N. Trivedi MD, MPH
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  2. John Z. Ayanian MD, MPP
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Correspondence to John Z. Ayanian MD, MPP.

Additional information

The authors have no conflicts of interest to disclose.

Dr. Trivedi was supported by an institutional National Research Service Award (#5 T32 HP11001-15) from the Health Resources and Services Administration.

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Trivedi, A.N., Ayanian, J.Z. Perceived discrimination and use of preventive health services. J Gen Intern Med 21, 553–558 (2006). https://doi.org/10.1111/j.1525-1497.2006.00413.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2006.00413.x

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