Perceived discrimination in health care and use of preventive health services

J Gen Intern Med. 2008 Oct;23(10):1679-84. doi: 10.1007/s11606-008-0730-x. Epub 2008 Jul 23.


Objective: To examine the relationship between perceived discrimination and preventive health care utilization.

Design and participants: Cross-sectional analysis using the 2004 Behavioral Risk Factor Surveillance System "Reactions to Race" module (N = 28,839).

Measurements: Outcomes were self-reported utilization of seven preventive health services. Predictors included perceived negative and positive racial discrimination (vs. none) while seeking health care in the past year. Multivariable models adjusted for additional patient characteristics.

Main results: In unadjusted models, negative discrimination was significantly associated with less utilization of mammogram, pap test, PSA test, blood stool test, and sigmoidoscopy/colonoscopy (ORs = 0.53-0.73, p < .05), but not flu or pneumococcal vaccines (ORs = 0.76 and 0.84). Positive discrimination was significantly associated with more utilization of all services (ORs = 1.29-1.58, p < .05) except pap test (OR = 0.94). In adjusted models, neither negative nor positive discrimination was predictive of utilization, except for PSA test (positive discrimination OR = 1.33, p < .05).

Conclusions: Perceived racial discrimination in health care does not independently predict preventive health care utilization.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Delivery of Health Care / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care*
  • Perception*
  • Prejudice*
  • Preventive Health Services / statistics & numerical data*
  • Risk Factors