Department of Sociology, University of New Brunswick, Fredericton, New Brunswick, Canada.
Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Health Promot Chronic Dis Prev Can. 2020 Nov/Dec;40(11-12):329-335. doi: 10.24095/hpcdp.40.11/12.01.
Weight-related social stigma is associated with adverse health outcomes. Health care systems are not exempt of weight stigma, which includes stereotyping, prejudice and discrimination. The objective of this study was to examine the association between body mass index (BMI) class and experiencing discrimination in health care.
We used data from the 2013 Canadian Community Health Survey, which included measurements of discrimination never collected previously on a national scale. Logistic regression analysis was used to assess the risk of self-reported discrimination in health care in adults (≥18 years) across weight categories: not obese (BMI < 30 kg/m2), obese class I (BMI = 30-< 35 kg/m2) and obese class II or III (BMI ≥ 35 kg/m2).
One in 15 (6.4%; 95% CI: 5.7-7.0%) of the adult population reported discrimination in a health care setting (e.g. physician's office, clinic or hospital). Compared with those in the not obese group, the risk of discrimination in health care was somewhat higher among those in the class I obesity category (odds ratio [OR] = 1.20; 95% CI: 1.00-1.44) and significantly higher among those in class II/III (OR = 1.52; 95% CI: 1.21-1.91), after controlling for sex, age and other socioeconomic characteristics.
Quantified experiences of weight-related discrimination underscore the need to change practitioner attitudes and practices as well as the policies and procedures of the health care system. More research is needed on the social and economic impacts of weight stigma to inform focused investments for reducing discrimination in the health care system as a microcosm of the society it reflects.
与体重相关的社会污名与不良健康结果有关。医疗保健系统也不能免除体重歧视，包括刻板印象、偏见和歧视。本研究的目的是检查体重指数（BMI）类别与医疗保健中经历歧视之间的关联。
我们使用了 2013 年加拿大社区健康调查的数据，其中包括以前从未在全国范围内收集的歧视测量。使用逻辑回归分析评估了体重类别（BMI<30kg/m2 为非肥胖，BMI=30-<35kg/m2 为肥胖 I 类，BMI≥35kg/m2 为肥胖 II 或 III 类）中成年人（≥18 岁）自我报告的医疗保健歧视风险。
15 分之一（6.4%；95%CI：5.7-7.0%）的成年人口报告在医疗保健环境中受到歧视（例如医生办公室、诊所或医院）。与非肥胖组相比，肥胖 I 类人群的医疗保健歧视风险略高（比值比[OR] = 1.20；95%CI：1.00-1.44），肥胖 II/III 类人群的风险显著更高（OR = 1.52；95%CI：1.21-1.91），在控制了性别、年龄和其他社会经济特征后。
量化的体重相关歧视经验强调需要改变从业者的态度和做法，以及医疗保健系统的政策和程序。需要进一步研究体重歧视的社会和经济影响，以为减少医疗保健系统歧视提供信息，因为医疗保健系统是其反映的社会的一个缩影。
