Secondary Studies on Discrimination

Social Discrimination and Health Care: A Multidimensional
Framework of Experiences among a Low-Income Multiethnic

A February 2018 article in Social Work In Public Health by Laura Hoyt D’Anna, Marissa Hansen, Brittney Mull, Carol Canjura, Esther Lee, and Stephanie Sumstine, the study aims to describe the perceived discriminatory health care treatment experiences and its impact on care among minority urban-dwelling adults. Semistructured qualitative interviews were conducted with patients from community-based health care settings. The study highlights the relevance of perceived discrimination in avoidance of health care services, nonadherence to treatment, and adverse health-related sequelae by low-income urban-dwelling adults with little access to health care.

Countywide Risk Assessment Survey (CRAS) 2004.

CHER staff, academic partners at CSULB, and members of the Los Angeles County Department of Health Services used data from the Countywide Risk Assessment Survey (CRAS) 2004 to investigate sexual orientation-based verbal harassment and how it relates to use of health services.  The results showed over a third of individuals experienced some form of verbal harassment and the majority of those individuals were lesbian, gay, or bisexual.  The individuals who reported verbal harassment also reported using more health services.  The results of this study demonstrate the linkage between discrimination and the use of healthcare services, which can shape future research examining the impact of discrimination on health and service utilization. 

Racial and ethnic health disparities: Evidence of discrimination’s effects across the SEP spectrum.

CHER staff and academic partners from UCLA conducted an original study using data from the 2001 California Health Interview Survey (CHIS) designed to: (1) explore perceived discrimination in receiving health care and its associations with racial/ethnic disparities in self-rated health status, physical and emotional functional limitations; (2) assess whether discrimination effects vary by racial/ethnic group and gender; and (3) evaluate the effects of discrimination on health across the socioeconomic position (SEP) spectrum.  All types of discrimination had a negative impact on self-rated health, and were associated with limitations in physical and emotional health. Negative health effects associated with discrimination occurred across the SEP spectrum, but fewer effects were experienced at higher levels of SEP. This study further shaped our understanding of discrimination as a complex social phenomenon mediated by other important factors such as SEP.

Does health care setting matter in reports of discrimination?

CHER staff and academic partners at USC conducted a study using data from the 2005 California Health Interview Survey (CHIS) to explore the relationship between adults’ usual health care setting type, SES, and perceived racial ethnic healthcare-related discrimination. Contrary to expectations, findings showed the perception of racial/ethnic discrimination was more common among adults who regularly used a community clinic or health center, or “other” setting, in comparison to private doctor’s office, but only among adults with mid-level (not lower or higher) SES. This study highlighted the complexity of discrimination and demonstrated a need for better understanding of the cause and effects of health care-based discrimination.