Discrimination in the health care system among higher-weight adults: Evidence from a canadian national cross-sectional survey

Abstract

Introduction: Weight-related social stigma is associated with adverse health outcomes. Health care systems are not exempt of weight stigma, which includes stereotyping, prejudice and discrimination. The objective of this study was to examine the association between body mass index (BMI) class and experiencing discrimination in health care. Methods: We used data from the 2013 Canadian Community Health Survey, which included measurements of discrimination never collected previously on a national scale. Logistic regression analysis was used to assess the risk of self-reported discrimination in health care in adults (≥18 years) across weight categories: Not obese (BMI<30 kg/m2), obese class I (BMI=30-<35 kg/m2) and obese class II or III (BMI≥35 kg/m2). Results: One in 15 (6.4%; 95% CI: 5.7-7.0%) of the adult population reported discrimination in a health care setting (e.g. physician’s office, clinic or hospital). Compared with those in the not obese group, the risk of discrimination in health care was somewhat higher among those in the class I obesity category (odds ratio [OR]=1.20; 95% CI: 1.00-1.44) and significantly higher among those in class II/III (OR=1.52; 95% CI: 1.21-1.91), after controlling for sex, age and other socioeconomic characteristics. Conclusion: Quantified experiences of weight-related discrimination underscore the need to change practitioner attitudes and practices as well as the policies and procedures of the health care system. More research is needed on the social and economic impacts of weight stigma to inform focused investments for reducing discrimination in the health care system as a microcosm of the society it reflects.