THURSDAY, Dec. 14, 2017 -- Nearly 20 percent of older people who've sought care for chronic illness say they experienced discrimination in the U.S. health system, a new study reports.
Racial discrimination was the most common kind, but the study also revealed discrimination based on ancestry, gender, age, religion, weight or physical appearance, physical disability, sexual orientation and financial status.
"If people believe they have received unfair treatment in the health care setting, that experience could negatively affect their experience with their providers, their willingness to go to their providers, and their adherence with their treatment, and thereby affect their health," said the study's first author, Thu Nguyen. She is a researcher at University of California, San Francisco.
"It's still very common, and there's a long way to go," Nguyen said in a UCSF news release.
For the study, the researchers looked specifically at reports of discrimination people experienced between 2008 and 2014. The reports came from a national survey of nearly 14,000 people aged 54 and older. All had a chronic disease, such as diabetes, cancer or high blood pressure.
People in all of the groups analyzed -- including blacks, whites and Hispanics -- said they had experienced discrimination.
Discrimination in health care has been linked to poor health and less use of health care services, according to the researchers.
The findings showed that discrimination reported by black patients declined over the six-year study period.
In 2008, when the survey began, 27 percent of black respondents reported discrimination. About 48 percent reported that it was based on race or ancestry, 29 percent reported age discrimination, and 20 percent reported discrimination based on income.
By 2014, however, the number of black survey participants reporting discrimination had fallen to 20 percent, about the same level as among whites. The researchers said they didn't know why this drop happened. Levels of discrimination among whites and Hispanics did not change significantly during that time period.
Among white survey participants, the most common reasons for reported discrimination were age (29 percent), weight or physical appearance (16 percent), gender (10 percent) and income (10 percent).
The most common type of discrimination reported by Hispanic participants was age (27 percent), followed by race or ancestry (23 percent), weight or physical appearance (14 percent) and income (14 percent).
The investigators also found that wealthier whites reported less discrimination, while wealthier blacks reported more.
The study's senior author, Amani Nuru-Jeter, said, "This finding is useful for continued efforts to improve health care experiences and suggests that a one-size-fits-all approach will not suffice." She's an associate professor of epidemiology and community health sciences at the University of California, Berkeley.
"Providers should be aware that a large fraction of patients will have experienced some form of discrimination in a health care setting," Nuru-Jeter noted. "Just by recognizing how common these experiences are for patients, clinicians may be able to offer better care."
The study was published Dec. 14 in the Journal of General Internal Medicine.More information
A joint statement from the World Health Organization and the United Nations discusses ending health care discrimination.
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