Unequal Treatment Confronting Racial and Ethnic Disparities in Health Care (2003) / Chapter Skim
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Appendix D: Racial Disparities in Healthcare: Hightlights from Focus Group Findings
Appendix D: Racial Disparities in Healthcare: Hightlights from Focus Group Findings
Pages 392-405
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From page 392... ...
During the eight focus groups, participants were asked to talk about their own personal experiences with racism in healthcare. When asked whether discrimination exists in receiving quality healthcare, one African-American participant summed up the collective response in this way: "The medical world just reflects the real world." Throughout the following section, participants' stories and opinions are presented in their own words, providing evidence of healthcare inequity that participants attributed directly or indirectly to racial or ethnic discrimination, their lack of English-language proficiency, or both.
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From page 393... ...
Language Barriers Many participants in the Chinese- and Spanish-speaking focus groups voiced concern about being treated unfairly because of their lack of English-language proficiency. As a result, they perceived that healthcare providers treat them differently and were concerned that they receive lower quality care.
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From page 394... ...
They said they encountered healthcare staff who ignored them and avoided trying to help them. Others pointed out instances where they or their family members have received poor quality healthcare services and have been treated disrespectfully because they speak little or no English.
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From page 395... ...
(Hispanic participant) The Role of Economics 395 Oftentimes, participants noted, a person's perceived or actual socioeconomic status can be an obstacle to obtaining quality healthcare services.
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From page 396... ...
(African-American participant) Others felt they must wait for long periods of time before receiving medications and other medical assistance, while whites are cared for first.
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From page 397... ...
In some instances, participants noted, racial and ethnic minority patients have difficulties gaining access to the specialists they need. One physician noted that specialists mistreat racial and ethnic minority patients to avoid having to provide treatment for them.
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From page 398... ...
As one African American participant aptly described, "It's hard to identify discrimination because they don't show it. They'll be sweet and smooth, all the way through it." Participants mentioned experiencing discrimination in many situations, but because of the subtleties often inherent in discrimination, it was challenging to identify overt examples.
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From page 399... ...
Patients' Economic/Insurance Status Some participants provided examples of how they or their family members received poor healthcare services because of their lack of insurance or perceived inability to pay for these services. They believed that they were being treated differently by the healthcare system, although they did not make a direct link to race or ethnicity.
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From page 400... ...
Healthcare Setting Native Americans, because of their unique access to healthcare through the Indian Health Service (IHS) , spoke often about the poor quality of care at the IHS clinics.
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From page 401... ...
Other Stories About Misdiagnosis or Improper Treatment Some participants spoke of going to the hospital or doctor and receiving misinformation or improper service from healthcare providers. In some cases, participants said their healthcare providers misdiagnosed their condition or were too passive in their treatment approach.
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From page 402... ...
(Hispanic participant) INSTITUTIONAL DISCRIMINATION IN HEALTHCARE In discussions with African-American and Hispanic physicians and nurses, they spoke not only about the discrimination their patients experience at the provider-patient level, but also cited examples of how healthcare institutions perpetuate discrimination in their policies and methods of practice.
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From page 403... ...
That's the bottom line." Participants felt that it is easier to develop a rapport or discuss treatment options with healthcare providers of their own race who already understand their language and cultural idiosyncrasies. I don't think necessarily you have to be an African American to provide good care to African Americans, but if you're not you really need to be aware of the culture and some of the issues in that culture, and really look at how you feel about dealing with peoplefrom that culture.
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From page 404... ...
In instances where healthcare providers or administrative staff are of a different race or ethnicity than the patients they are treating, participants expressed a desire for more patience and respect from their providers. They felt that doctors and nurses who are treating a high proportion of patients from a particular racial or ethnic group should be familiar with relevant customs that may impact patients' healthcare decisions.
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From page 405... ...
While racial and ethnic discrimination is not always easy to recognize or recall, participants offered many concrete examples of discriminatory situations they encountered. This research adds to the growing body of literature examining racial and ethnic disparities in healthcare and provides evidence of both interpersonal and institutional discrimination.
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