Race and Ethnicity as Factors in Healthcare Discrimination in the United States: A Cross-Sectional Study.

BACKGROUND AND PURPOSE

Discrimination is the unfair or prejudicial treatment of people and groups based on certain characteristics. Discrimination in health care can impede access to quality care for patients and lead to poor health outcomes. This study aimed to investigate factors, including race and ethnicity, associated with discrimination in health care in the United States.

METHODS

A cross-sectional study utilizing the 2021 Medical Expenditure Panel Survey (MEPS) was conducted. Adults (≥ 18 years old) who responded to questions about discrimination in health care were identified. Population characteristics were summarized using weighted mean, standard deviation, and percentages. A weighted t-test for continuous variables and a chi-square test for categorical variables were used to compare subject characteristics. Weighted logistic regression was used to explore factors associated with discrimination in health care, while controlling for important covariates.

RESULTS

A total of 238,097,086 participants (unweighted n = 17,239) were included in the study. Average (SD) age of the population was 48 (18) years old in 2021 and 52% were female. Compared to non-Hispanic White population, non-Hispanic Black and non-Hispanic other races were more likely to experience discriminated when receiving health care by 285% (OR = 3.85, p < 0.001) and 207% (OR = 3.07, p < 0.001), respectively. Females were also more likely to experience discrimination than males (OR = 1.97, p < 0.001). Other factors associated with discrimination in health care were asthma diagnosis, being a smoker and poverty.

CONCLUSION

Discrimination in health care is associated with being part of a minority racial and ethnic groups, being female, being an older individual, being a smoker and living in poverty. These associations may contribute to inequitable health outcomes in the United States.