Report of racially-based unfair treatment in healthcare: Analysis by age, gender and socioeconomic position

Report of unfair race-based treatment has been associated with many health outcomes. Experience of racism in healthcare may lead to delays in seeking and adhering to treatment, thus contributing to health disparities. Little attention has been paid to how report of unfair treatment varies by age, gender, and socioeconomic position, with such factors usually being treated as control/nuisance variables. There is evidence that males and those with higher educational attainment may report more discrimination. Although older people may have lived through times of significant institutional racism, they seem to report less lifetime discrimination. We use data from the 2004 Behavioral Risk Factor Surveillance Survey Reaction to Race Module from 7 states and the District of Columbia, analyzing reports of unfair treatment when seeking healthcare (N=37,515, 5927 non-Hispanic Blacks, 28,519 non-Hispanic Whites, 444 non-Hispanic multiracial, 943 non-Hispanic others, and 1682 Hispanics) by age, gender, and educational attainment). Using ordinal logit analysis, we find that, compared to non-Hispanic whites, other race categories were more likely to report unfair treatment in seeking healthcare (non-Hispanic black OR=9.6 95%CI=5.4-8.9, Hispanic OR=2.0 95%CI=1.3-3.2, Non-Hispanic multiracial OR=2.4, 95%CI=1.1-5.3, non-Hispanic other OR=2.3, 95%CI=1.3-4.3). Mid-adults were most likely to report (OR= 10.0, 95%CI=4.9-20.2 ages 45-49 versus ages 80+) with reports monotonically dropping with increasing age. Compared with men, women were less likely to report unfair treatment (OR=0.70, 95%CI=0.57-0.85); those graduating from college were also more likely to report (OR=4.4, 95%CI=5.8 compared with high-school only). Further investigation should also consider such factors as mental health, self-rated health, and race consciousness.