Perceived discrimination in health care and health status in a racially diverse sample

Med Care. 2008 Sep;46(9):905-14. doi: 10.1097/MLR.0b013e3181792562.


Background: Despite the surge of recent research on the association between perceived discrimination and health-related outcomes, few studies have focused on race-based discrimination encountered in health care settings. This study examined the prevalence of such discrimination, and its association with health status, for the 3 largest race/ethnic groups in the United States.

Methods: Data were drawn from the 2004 Behavioral Risk Factor Surveillance System survey. The primary variables were perceived racial discrimination in health care and self-reported health status. Multivariable logistic regression was used to compare the prevalence of perceived discrimination for whites, African Americans, and Hispanics, and to examine the association between perceived discrimination and health status, controlling for sex, age, income, education, health care coverage, affordability of medical care, racial salience, and state.

Results: Perceived discrimination was reported by 2%, 5.2%, and 10.9% of whites, Hispanics, and African Americans, respectively. Only the difference between African Americans and whites remained significant in adjusted analyses [odds ratio (OR) = 3.22, 95% confidence interval (CI) = 2.46-4.21]. Racial/ethnic differences in perceived discrimination depended on income, education, health care coverage, and affordability of medical care. Perceived discrimination was associated with worse health status for the overall sample (OR = 1.71, 95% CI = 1.35-2.16). Stratified analyses revealed that this relationship was significant for whites (OR = 2.00, 95% CI = 1.45-2.77) and African Americans (OR = 1.95, 95% CI = 1.39-2.73), but not for Hispanics (OR = 0.55, 95% CI = 0.24-1.22).

Conclusions: Perceived racial discrimination in health care is much more prevalent for African Americans than for whites or Hispanics. Furthermore, such discrimination is associated with worse health both for African Americans and for whites.

Publication types

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

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Black or African American / psychology*
  • Black or African American / statistics & numerical data
  • Cross-Sectional Studies
  • Culture*
  • Female
  • Health Services Research
  • Health Status*
  • Healthcare Disparities*
  • Hispanic or Latino / psychology*
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Insurance Coverage / statistics & numerical data
  • Male
  • Middle Aged
  • Odds Ratio
  • Prejudice*
  • Sex Factors
  • United States
  • White People / psychology*
  • White People / statistics & numerical data