Correlates of patient-reported racial/ethnic health care discrimination in the Diabetes Study of Northern California (DISTANCE)

J Health Care Poor Underserved. 2011 Feb;22(1):211-25. doi: 10.1353/hpu.2011.0033.

Abstract

Objectives: We examined possible determinants of self-reported health care discrimination.

Methods: We examined survey data from the Diabetes Study of Northern California (DISTANCE), a race-stratified sample of Kaiser diabetes patients. Respondents reported perceived discrimination, and regression models examined socioeconomic, acculturative, and psychosocial correlates.

Results: Subjects (n=17,795) included 20% Blacks, 23% Latinos, 13% East Asians, 11% Filipinos, and 27% Whites. Three percent and 20% reported health care and general discrimination. Health care discrimination was more frequently reported by minorities (ORs ranging from 2.0 to 2.9 compared with Whites) and those with poorer health literacy (OR=1.10, 95% CI: 1.04-1.16), limited English proficiency (OR=1.91, 95% CI: 1.32-2.78), and depression (OR=1.53, 95% CI: 1.10-2.13).

Conclusions: In addition to race/ethnicity, health literacy and English proficiency may be bases of discrimination. Evaluation is needed to determine whether patients are treated differently or more apt to perceive discrimination, and whether depression fosters and/or follows perceived discrimination.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Asia, Eastern / ethnology
  • Asian / psychology*
  • Asian / statistics & numerical data
  • Attitude to Health
  • Black People / psychology*
  • Black People / statistics & numerical data
  • California
  • Communication Barriers
  • Depression / ethnology
  • Diabetes Mellitus / ethnology*
  • Female
  • Health Care Surveys
  • Health Literacy / statistics & numerical data
  • Healthcare Disparities / ethnology*
  • Hispanic or Latino / psychology*
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Minority Groups / psychology
  • Minority Groups / statistics & numerical data
  • Philippines / ethnology
  • Prejudice*
  • Professional-Patient Relations
  • Socioeconomic Factors
  • White People / psychology*
  • White People / statistics & numerical data