Black and African American Adults’ Perspectives on Discrimination and Unfair Judgment in Health Care

Research Report

Black and African American Adults’ Perspectives on Discrimination and Unfair Judgment in Health Care

Abstract

In this brief, we present findings from follow-up interviews with 39 Black and African American nonelderly adults ages 18 to 64 who participated in the Urban Institute’s September 2020 Coronavirus Tracking Survey. We designed our follow-up interviews to explore accounts of discrimination and unfair judgment and assess their consequences. Interviews took place between December 2020 and February 2021. We find the following:

  • The sample of adults commonly experienced unfair judgment by a doctor, health care provider, or their staff or knew someone who had.
    • Among the 39 people we interviewed, 22 reported personally experiencing discrimination or unfair judgment when seeking health care at some point in their lives.
    • Among the 17 people with no such personal experience, nearly half knew a family member or friend who had had such experiences.
  • Perceived discrimination and unfair judgment were rarely overt, and many people we interviewed could not discern whether their mistreatment was because of their race specifically or because of a combination of factors, including income, gender, health conditions, and disability.
  • Some people were more hesitant than others to label an experience as discrimination without clearer proof or evidence, yet they described encounters that health care research defines as likely discrimination.
  • Delayed treatment and critical misdiagnoses were notable negative consequences of perceived discrimination or unfair judgment by doctors, health care providers, or their staff.
  • Though most people planned to get a COVID-19 vaccine when it became available to them, most were hesitant about the decision. Those who had experienced perceived discrimination or unfair judgment were more hesitant about the vaccines than those who had not had such experiences.

This brief is part of a body of work exploring perceptions of discriminatory experiences in health care and other settings. See the related publications.

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