Provider communication quality: influence of patients' weight and race

Patient Educ Couns. 2015 Apr;98(4):492-8. doi: 10.1016/j.pec.2014.12.007. Epub 2015 Jan 7.


Objective: To examine the relationship between patient weight and provider communication quality and determine whether patient race/ethnicity modifies this association.

Methods: We conducted a cross-sectional analysis with 2009-2010 medical expenditures panel survey-household component (N=25,971). Our dependent variables were patient report of providers explaining well, listening, showing respect, and spending time. Our independent variables were patient weight status and patient weight-race/ethnicity groups. Using survey weights, we performed multivariate logistic regression to examine the adjusted association between patient weight and patient-provider communication measures, and whether patient race/ethnicity modifies this relationship.

Results: Compared to healthy weight whites, obese blacks were less likely to report that their providers explained things well (OR 0.78; p=0.02) or spent enough time with them (OR 0.81; p=0.04), and overweight blacks were also less likely to report that providers spent enough time with them (OR 0.78; p=0.02). Healthy weight Hispanics were also less likely to report adequate provider explanations (OR 0.74; p=0.04).

Conclusion: Our study provides preliminary evidence that overweight/obese black and healthy weight Hispanic patients experience disparities in provider communication quality.

Practice implication: Curricula on weight bias and cultural competency might improve communication between providers and their overweight/obese black and healthy weight Hispanic patients.

Keywords: Health disparities; Obesity; Provider communication.

MeSH terms

  • Adult
  • African Americans / psychology
  • African Americans / statistics & numerical data
  • Aged
  • Attitude of Health Personnel*
  • Body Weight
  • Communication*
  • Continental Population Groups / psychology*
  • Continental Population Groups / statistics & numerical data
  • Cross-Sectional Studies
  • Ethnic Groups / psychology
  • Ethnic Groups / statistics & numerical data
  • European Continental Ancestry Group / psychology
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Health Services Accessibility
  • Hispanic Americans / psychology
  • Hispanic Americans / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Obesity / ethnology*
  • Physician-Patient Relations*
  • Socioeconomic Factors
  • United States