Patient perceptions of the impact of race and culture on healthcare interactions

Background Racial inequities in healthcare persist via structural and individual level mechanisms. Structural factors, such as income and access to quality healthcare services, are referenced more often than individual drivers of racial inequities in healthcare, such as communication and cultural appropriateness during healthcare interactions. Examining Black patients perceptions of healthcare providers’ behaviors can strengthen our knowledge of how patient-provider interactions may contribute to racial inequities in healthcare. Methods Data were collected in the context of a colorectal cancer (CRC) screening program based in a free medical clinic in South Carolina. A series of three semi-structured interviews were conducted Black participants of the program. Clinical observations, document reviews, and interviews with patient navigators and clinical staff were conducted as part of an ethnographic case study. Results Thirty interviews have been completed with navigation patients and clinic staff. Of the 10 patients interviewed, half are female and have a mean age of 55 (SD=4.55) years. Most patients had a high school education (70%). Data collection is ongoing but preliminary results reveal that patients describe quality communication as when providers take time to explain medical issues and show concern. Patients believe that quality communication as central to positive healthcare interactions and that patients’ race and socioeconomic status (SES) influenced whether they received quality communication.  Conclusions By exploring the experiences of lower SES Blacks’ healthcare experiences meaningful information can be gathered about how individual level factors contribute to racial inequities in healthcare experiences and outcomes.