Unfair Racial Treatment in Healthcare, Healthcare Utilization, and Health Status Among Black, Indigenous, Women of Color

Abstract

Black, Indigenous, Women of Color (BIWOC) face well-documented health disparities in the United States. However, the extent to which recent experiences of unfair racial treatment in medical settings contribute to health disparities is not well understood. The objective of this study was to examine associations of experiencing unfair racial treatment by a provider during the most recent medical encounter with healthcare utilization and health status in BIWOC. We utilized multivariate logistic regression models to examine data from the Association of American Medical Colleges’ biannual Survey of Healthcare Access collected between 2012 and 2019. Data were extracted for 5,549 participants who identified both as a woman and a Black, Indigenous, Person of Color to generate our BIWOC sample of interest. Among BIWOC, experiencing unfair racial treatment during their most recent healthcare visit in the past year was associated with higher odds of delaying healthcare ( OR = 3.50, p < .001) and using the emergency department as their usual source of care ( OR = 1.54, p < .001). Experiencing unfair racial treatment was also associated with having chronic physical conditions ( OR = 1.31, p = .002), chronic depression ( OR = 1.56, p < .001), and activity limitations due to both emotional ( OR = 2.98, p < .001) and physical ( OR = 2.47, p < .001) impairment. Recent experience of racial discrimination by a healthcare provider was associated with lower healthcare utilization and poorer health status in a national sample of BIWOC. Reducing unfair treatment in healthcare settings is critical for improving BIWOC health.