224249 Experiences of medical care-related discrimination: Important lessons learned from a study including California's safety-net clinics

Monday, November 8, 2010 : 10:45 AM - 11:00 AM

Laura Hoyt D'Anna, DrPH , Center for Health Care Innovation, California State University, Long Beach, Long Beach, CA
Gregory D. Stevens, PhD , Center for Community Health Studies, University of Southern California, Alhambra, CA
Kai Ya Tsai, MSPH , Center for Community Health Studies, University of Southern California, Alhambra, CA
C. Kevin Malotte, DrPH , Center for Health Care Innovation, California State University, Long Beach, Long Beach, CA
We investigated the associations between the type of health care setting that California adults report as their regular source of care: “Doctor's Office” (doctor's office/Kaiser/other HMO); Likely “Safety-net Clinic Users” (clinic/health center/hospital clinic), limited to those who were at or below 200% federal poverty level and had public insurance (Medicaid or Healthy Families) or were uninsured; Likely “Non-safety Net Clinic Users” (clinic/health center/hospital clinic), limited to those whose income was greater than 200% FPL and had insurance that was not publicly funded; “Other” (emergency room/alternative medical care/family/friend/other, or no one place); and those who had “No Usual Source of Care,” and perceived racial/ethnic medical care-related discrimination. Data were analyzed from the 2005 California Health Interview Survey, a cross-sectional survey using a geographically stratified random digit dial sample of California households (n= 36,694 adults who visited a physician in the past year). “Non-safety Net Clinic Users” had increased odds for perceived racial/ethnic discrimination (OR 1.76, CI:1.32-2.35), whereas ”Safety-net Clinic Users” users appear to experience discrimination at rates that are similar to those seeking care at private and HMO doctor's offices. Additionally, African-Americans had the greatest odds for perceiving racial/ethnic discrimination (OR 3.42, CI: 2.40-4.87). Our findings suggest that much could be done to improve the experiences of adults seeking care in Non-safety Net Clinics. Safety-net clinics might serve as models for delivering care since they are already dedicated to serving vulnerable populations and are committed to implementing initiatives designed to reduce health disparities and enhance social justice.

Learning Areas:
Diversity and culture
Ethics, professional and legal requirements
Provision of health care to the public
Public health administration or related administration
Public health or related organizational policy, standards, or other guidelines
Social and behavioral sciences

Learning Objectives:
1.)To understand the importance of conducting a refined analysis of previously explored data to account for differences in socioeconomic status and time concurrency in key measures and to analyze the resultant varied conclusions. 2.)To discuss factors related to medical care-related discrimination and the implications for social justice within California’s health care delivery system.

Keywords: Social Justice, Community-Based Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I completed my dissertation on California health disparities and the negative health impacts resulting from discrimination and I have studied these issues for the past 7 years. I am also a senior research fellow for CSULB and serve as assistant director for an NIH-funded RIMI Project designed to advance quality research in the field of health disparities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.