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African American preference for same race health care providers: The role of perceived health care discrimination

Jennifer R. Malat, PhD, Department of Sociology, University of Cincinnati, P.O. Box 210378, Cincinnati, OH 45221, (513)556-4709, Jennifer.Malat@uc.edu

Researchers have assumed that patient preferences influence the race of patients’ healthcare providers, but the nature of preferences and what factors inform them have not been clarified. The primary goals of this paper are to determine the extent to which African Americans prefer same race healthcare providers and the extent to which 1) knowledge of historical mistreatment, 2) perceptions of current racial inequities in medical treatment, and 3) personal experiences of discrimination are associated with preference for same race healthcare providers among African Americans. To assess these questions, the 1999 Kaiser Family Foundation nationally representative telephone survey, “Americans’ Perceptions of Racial Disparities in Health Care,” is used. 1,189 African Americans were included in the sample. The dependent variable was measured by asking, “If you had to choose, would you prefer to be treated by a doctor or nurse of your own race or ethnic group, or not?” Knowledge of past mistreatment was assessed through knowledge of the Tuskegee Syphilis Study. Perceptions of current inequities were measured by how often respondents think “a person’s race or ethnic background affects whether they can get routine medical care when they need it” and “specialized treatments or surgery.” Personal experiences of racial discrimination were assessed with two items: whether during the past few years the respondent had been treated unfairly when seeking medical care because of racial or ethnic background and whether someone in the respondent’s family had that experience. Bivariate significance was determined using chi-square tests. Multinominal logistic regression models adjust for age, gender, income, education, and self-reported health status. Approximately 20 percent African Americans stated a preference for a same race healthcare provider. Neither knowledge of historical mistreatment nor perceptions of current racial inequities in medical treatment are related to preferred race of healthcare providers. In contrast, personal experiences of discrimination in healthcare are associated with a preference for same-race healthcare providers. The results suggest that while knowledge of historical unfair treatment and perceptions of current racial inequity do not affect choices, personal experiences of unfair treatment have a significant effect on African American patients’ preferences and choices regarding health care. This research leads to questions for future research. For instance, how do experiences of unfair treatment influence other health related attitudes and behaviors? What kinds of experiences do respondents have in mind when they report unfair racial treatment? How does the nature of medical problem influence preferred healthcare provider race?

Learning Objectives:

Presenting author's disclosure statement:
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.

Studies on Disparities in Perceptions and Use of Services (Ethnic and Racial Disarities Contributed Papers #3)

The 132nd Annual Meeting (November 6-10, 2004) of APHA