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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Elizabeth A. Jacobs, MD, MPP, Eric E. Whitaker, MD, MPH, Romina Kee, MD MPH, Rael Slavensky, RN MS, and Marjorie Charles-Damte, RN. Collaborative Research Unit, Cook County Hospital and Rush University, 1900 W Polk St, 16th Floor, Chicago, IL 60612, 312-633-6781, ejacobs@rush.edu
BACKGROUND: The debate over whether and how race and ethnicity variables should be used in research continues to grow. Academic arguments for and against asking about race and ethnicity have been clearly delineated but very little is known about what patients think about these variables or questions asking them to identify their race and/or ethnicity. The purpose of this study was to explore the meaning of race and ethnicity to the patient population we serve and their attitudes towards questions about their race and/or ethnicity. METHODS: Six focus groups were conducted by culturally appropriate focus group leaders with a convenient sample of patients from one of three Cook County clinics. The interview guide contained questions addressing the meaning of the terms race and ethnicity, self and external identification, the appropriateness of asking about race and ethnicity in the health care setting and how well they thought the census captured this information. Discussions were audio taped, transcribed and coded for interpretation using grounded theory. STUDY POPULATION: Twenty -three African American patients 20 to 76 years of age and 11 Spanish-speaking patients 18 to 60 years of age. RESULTS: Common themes included: 1. Categorization of race leads to discrimination. 2. Questions about race and ethnicity in the health care setting may or may not be appropriate. Participants thought it was appropriate if they believed the information was used to target care and inappropriate if they believed it was used as a means of discrimination. 3. Their willingness to answer these questions depended on how and why they were asked. 4. The 2000 Census questions were confusing and difficult to answer. Themes specific to African Americans included confusion regarding the difference between the terms race and ethnicity and the lability of the terms used to identify them over time. They discussed how racial and ethnic labels had changed over time and identification preferences differed between generations. Spanish-speaking patients made a clearer distinction between race and ethnicity, viewing race as "pedigree" and ethnicity a representation of one's national/cultural origin. They considered questions about race rude and preferred questions about ethnicity. CONCLUSION: While academics and health care providers think they are doing the best for patients by asking them to identify their race and/or ethnicity their minority patients may view their motives very differently. Culturally sensitive methods and tools should be developed to collect this information in a valid and non-threatening manner.
Learning Objectives:
Keywords: Data Collection, Minority Research
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Cook County Hospital
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.