Institute of Medical Sociology, University Medical Center Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
Int J Equity Health. 2024 Feb 26;23(1):39. doi: 10.1186/s12939-024-02132-4.
It has consistently been shown that perceived discrimination is associated with adverse health outcomes. Despite this uncontested relevance, there is a lack of research on the experiences of discrimination in health care. Therefore, the following research questions were addressed: (1) How often do people in Germany report having been discriminated in health care due to different reasons? (2) Which socio-demographic groups are most afflicted by perceived discrimination in health care?
Analyses are based on a cross-sectional online survey conducted in Germany. An adult population sample was randomly drawn from a panel which was recruited offline (N = 2,201). Respondents were asked whether they have ever been discriminated in health care due to the following reasons: age, sex/gender, racism (i.e. migration history, religion, language problems, colour of skin), health issues or disability (i.e. overweight, mental illness/addiction, disability), socio-economic status (SES, i.e. income, education, occupation).
26.6% of the respondents reported discrimination experiences. Perceived discrimination due to health issues or disability was most frequent (15%), followed by age (9%) and SES (8.9%). Discrimination due to racism and sex/gender was less frequently reported (4.1% and 2.5%). Younger age groups, women, and 2nd generation migrants as well as respondents with low income and low education were more likely to report any kind of discrimination in health care. Two groups were found to be at special risk for reporting discrimination in health care across different reasons: women and younger age groups. Discrimination due to racism was more prevalent among respondents who have immigrated themselves than those who were born in Germany but whose parents have immigrated. Discrimination due to SES was significantly associated with (low) income but not with education.
More than a quarter of the adult population in Germany reported experiences of discrimination in health care. Such experiences were more frequent among lower SES groups, migrants, women, and younger people. Results underline the necessity of interventions to reduce the magnitude and consequences of discrimination in health care. Future studies should apply an intersectional approach to consider interactions between social inequality indicators regarding discrimination and to identify risk groups that are potentially afflicted by multiple discrimination.
一直以来，人们都清楚地认识到，感知到的歧视与不良健康结果有关。尽管这一关联性不容置疑，但在医疗保健领域中，关于歧视经历的研究却很匮乏。因此，提出了以下研究问题：（1）在德国，人们因不同原因在医疗保健中受到歧视的频率有多高？（2）哪些社会人口群体最容易受到医疗保健中感知到的歧视？
本分析基于在德国进行的一项横断面在线调查。从线下招募的一个小组中随机抽取了成年人口样本（N=2201）。受访者被问及他们是否因以下原因在医疗保健中受到歧视：年龄、性别/性别、种族（即移民历史、宗教、语言问题、肤色）、健康问题或残疾（即超重、精神疾病/成瘾、残疾）、社会经济地位（SES，即收入、教育、职业）。
26.6%的受访者报告了歧视经历。因健康问题或残疾而产生的感知歧视最为常见（15%），其次是年龄（9%）和 SES（8.9%）。因种族和性别/性别而产生的歧视报告较少（分别为 4.1%和 2.5%）。年龄较小的群体、女性和第二代移民以及收入较低和受教育程度较低的受访者更有可能报告在医疗保健中受到任何形式的歧视。有两个群体在因不同原因报告医疗保健中的歧视方面处于特殊风险之中：女性和年龄较小的群体。因自己移民而来的受访者中，因种族而产生的歧视比那些在德国出生但父母移民而来的受访者更为普遍。因 SES 产生的歧视与（低）收入显著相关，但与教育无关。
德国超过四分之一的成年人口报告了在医疗保健中受到歧视的经历。SES 较低的群体、移民、女性和年轻人更频繁地出现这种经历。研究结果强调了采取干预措施减少医疗保健中歧视的程度和后果的必要性。未来的研究应采用交叉性方法，考虑社会不平等指标之间的相互作用，以确定可能受到多种歧视影响的风险群体。
