Community perceptions of health disparities: Results from an evaluation of a faith-based coalition

Background: Bronx Health REACH (BHR), a coalition of over 70 community-based organizations, developed a Faith-Based Outreach Initiative (FBOI) to engage churches in health education, promotion, and advocacy related to the impact of disparities in health care access and treatment.

Methods: We administered baseline surveys to congregants present at church services at 20 Bronx and Harlem churches (9 Latino/11 Black). Surveys asked participants to define health disparities and to note experiences and attitudes regarding disparate care.

Results: A total of 1,865 congregants (65% Black/35% Latino) completed the survey. Respondents were primarily female (69%) and high school graduates (76%). Twenty-one percent of survey respondents were Spanish speakers. Forty percent of participants reported personal experience with disparate care, and 75% felt that the healthcare system treats people unfairly because of race or ethnicity. Participants with at least a high school diploma reported more personal experience with disparate care (40% vs. 32%, p=0.0362) and unfair treatment (79% vs. 64%, p<0.0001) as compared to those without a diploma. English proficient participants reported more personal experience with disparate care (41% vs. 36%, p=0.0423) and unfair treatment (81% vs. 67%, p<0.0001) than Spanish speakers. Comparable trends were found when results were stratified by gender, race/ethnicity, and regular place of care (clinics versus private doctor's offices).

Conclusions: Significant proportions of study participants perceive and experience disparities in the health care system. Greater awareness of disparities among more educated and English proficient participants suggests that Spanish speakers and the less educated may have inadequate knowledge regarding optimal health care.