Article Figures & Data
Tables
- Table 1.
Sample Characteristics, Adult California Health Interview Survey, 2015–2017 (n = 63,100)
N % SE Perceived discrimination in health care No 44,619 71.48 0.6 Yes 18,481 28.52 0.6 Main reason for discrimination in health care Did not experience discrimination 44,619 71.48 0.6 Dissatisfaction with the health care system 4,476 5.63 0.3 Race or skin color 2,709 5.23 0.25 Age 1,979 2.44 0.18 Way respondent speaks English or other barrier to communication 1,358 3.19 0.18 Insurance status or type 1,308 2.07 0.14 Income or education 991 1.52 0.12 Type of insurance coverage Employer-sponsored coverage 20,646 42 0.58 Medicaid 10,062 21.25 0.4 Private coverage, Covered California 1,726 3.08 0.18 Private coverage, off-exchange 2,028 3.88 0.25 Medicare and Medicaid 5,464 5.5 0.17 Medicare alone or with other insurance 18,392 13.46 0.23 Other public sponsored coverage 761 1.4 0.12 Uninsured 4,021 9.43 0.29 Delayed or didn't get needed prescription in past 12 months No 59,472 94.41 0.26 Yes 3,628 5.59 0.26 Delayed or didn't get needed medical care in past 12 months No 58,609 93.23 0.27 Yes 4,491 6.77 0.27 Site of usual source of care Doctor's office or HMO 38,851 54.95 0.46 No usual source of care 6,809 15.24 0.34 Clinic or health center 15,878 26.99 0.41 Emergency room 909 1.79 0.17 Other or no one place 653 1.02 0.11 Race/ethnicity White 36,816 41.53 0.04 Latino 15,021 35.51 0.01 Black 3,284 5.59 0 Asian 5,555 14.3 0.01 Other 2,424 3.07 0.04 Citizenship status US-born citizen 48,551 66.69 0.43 Naturalized citizen 8,688 17.59 0.34 Noncitizen 5,861 15.72 0.36 Limited English proficiency No 52,100 74.37 0.47 Yes 11,000 25.63 0.47 Gender Male 27,563 48.83 0.01 Female 35,537 51.17 0.01 Educational attainment Less than bachelor's degree 37,168 61.92 0.38 Bachelor's degree or above 25,932 38.08 0.38 Age, y 18–29 8,368 22.1 0 30–39 6,384 18.02 0 40–49 7,306 17.26 0 50–59 11,166 16.43 0.2 60–69 13,660 14.16 0.35 70+ 16,216 12.01 0.3 Household income (as % of FPL) 0–138% of FPL 15,169 26.6 0.57 139–249% of FPL 10,822 17.26 0.37 250–399% of FPL 10,067 16.13 0.42 400% of FPL and higher 27,042 40 0.04 Urban or rural residence Rural 11,758 9.96 0.36 Urban 51,342 90.04 0.36 Health status Excellent, very good, or good 49,205 77.91 0.44 Fair or poor 13,895 22.09 0.44 Visual or hearing problem or impairment No 6,743 7.95 0.24 Yes 56,357 92.05 0.24 Chronic condition No 30,088 56.83 0.44 Yes 33,012 43.17 0.44 Survey year 2015 21,034 33.12 0 2016 20,916 33.34 0.01 2017 21,150 33.54 0 FPL, Federal poverty level; SE, standard error; HMO, health maintenance organization.
All frequencies and standard errors are weighted. Sample sizes are unweighted.
- Table 2.
Logistic Regression Models for Odds of Perceiving Discrimination in Health Care, by Reason for Discrimination (n = 63,100)
Reason for Discrimination Dissatisfaction with Health Care Race or Skin Color Age Way Respondent Speaks English or Other Barrier to Communication Insurance Status or type Income or Education Any Reason AOR 95%CI AOR 95%CI AOR 95%CI AOR 95%CI AOR 95%CI AOR 95%CI AOR 95%CI Type of insurance coverage Employer-sponsored coverage Reference Reference Reference Reference Reference Reference Reference Medicaid 1.16 (0.86, 1.56) 1.41 (1.04, 1.90) 0.85 (0.51, 1.41) 0.77 (0.48, 1.23) 1.25 (0.79, 1.98) 1.52 (0.78, 2.96) 1.28 (1.10, 1.50) Private coverage, Covered California 1.17 (0.62, 2.21) 0.99 (0.53, 1.85) 1.11 (0.62, 2.00) 1.12 (0.54, 2.33) 0.88 (0.40, 1.92) 1.48 (0.41, 5.33) 1.25 (0.92, 1.70) Private coverage, off-exchange 0.65 (0.43, 0.99) 0.68 (0.31, 1.48) 1.25 (0.69, 2.30) 0.88 (0.36, 2.19) 0.82 (0.12, 5.63) 1.70 (0.70, 4.13) 0.92 (0.72, 1.17) Medicare and Medicaid 0.95 (0.62, 1.46) 1.26 (0.80, 2.00) 0.87 (0.50, 1.56) 0.73 (0.35, 1.53) 0.85 (0.43, 1.69) 1.54 (0.72, 3.26) 1.14 (0.82, 1.58) Medicare alone or with other insurance 0.98 (0.73, 1.31) 0.85 (0.52, 1.38) 0.98 (0.61, 1.59) 0.82 (0.39, 1.71) 0.76 (0.43, 1.36) 0.73 (0.32, 1.67) 1.06 (0.83, 1.34) Other public sponsored coverage 1.36 (0.72, 2.60) 0.58 (0.27, 1.26) 1.11 (0.34, 3.62) 0.37 (0.08, 1.69) 0.76 (0.23, 2.50) 0.98 (0.32, 3.03) 1.07 (0.73, 1.59) Uninsured 0.95 (0.65, 1.39) 1.21 (0.80, 1.83) 1.00 (0.44, 2.23) 0.71 (0.40, 1.25) 0.84 (0.44, 1.61) 1.07 (0.52, 2.19) 0.99 (0.79, 1.24) Site of usual source of care Doctor's office or HMO Reference Reference Reference Reference Reference Reference Reference No usual source of health care 0.76 (0.49, 1.18) 1.02 (0.71, 1.48) 1.09 (0.61, 1.95) 0.92 (0.63, 1.34) 1.35 (0.79, 2.42) 0.96 (0.56, 1.65) 0.96 (0.82, 1.13) Clinic or health center 1.07 (0.88, 1.29) 1.00 (0.80, 1.26) 1.27 (0.82, 1.96) 1.19 (0.83, 1.71) 1.05 (0.72, 1.52) 1.06 (0.69, 1.62) 1.10 (0.98, 1.24) Emergency room 1.30 (0.63, 2.72) 1.29 (0.72, 2.31) 0.85 (0.22, 3.28) 1.06 (0.46, 2.48) 1.67 (0.64, 3.55) 1.05 (0.40, 2.76) 1.54 (1.12, 2.10) Other or no one place 2.16 (1.03, 4.51) 1.38 (0.64, 2.99) 1.68 (0.58, 4.88) 0.35 (0.08, 1.61) 0.48 (0.24, 3.17) 0.64 (0.20, 2.02) 1.20 (0.80, 1.80) Other comparisons Covered California versus off-exchange 1.81 (0.95, 3.43) 1.46 (0.64, 3.31) 0.88 (0.43, 1.82) 1.27 (0.40, 3.99) 1.07 (0.12, 9.74) 0.87 (0.18, 4.18) 1.36 (0.90, 2.06) AOR, adjusted odds ratio; HMO, health maintenance organization, CI, confidence interval.
Significant associations denoted in bold, at P < .05.
All models control for race, citizenship status, gender, educational attainment, age, household income, health status, diagnosis of chronic conditions, visual or hearing problem or impairment, survey year, and urban or rural residence.
- Table 3.
Logistic Regression Models for Odds of Perceiving Discrimination in Health Care, by Reason for Discrimination with Interactions by Race (n = 63,100)
Reason for discrimination Race or Skin Color Any Reason AOR 95%CI AOR 95%CI Type of insurance coverage Employer-sponsored coverage Reference Reference Medicaid 3.49 (1.97, 6.15) 1.81 (1.42, 2.30) Private coverage, Covered California 0.93 (0.30, 2.88) 1.33 (0.80, 2.21) Private coverage, off-exchange 0.85 (0.25, 2.96) 1.21 (0.89, 1.63) Medicare and Medicaid 2.41 (0.96, 6.04) 1.54 (1.07, 2.23) Medicare alone or with other insurance 0.54 (0.25, 1.16) 1.18 (0.94, 1.47) Other public sponsored coverage 0.40 (0.06, 2.84) 0.99 (0.62, 1.61) Uninsured 2.64 (0.24, 29.15) 1.16 (0.71, 1.91) Race/ethnicity White Reference Reference Latino 5.41 (3.06, 9.55) 1.17 (0.97, 1.41) Asian 4.85 (2.86, 8.25) 0.76 (0.59, 0.98) Black 20.12 (10.73, 37.75) 1.94 (1.31, 2.89) Other 10.60 (5.28, 21.29) 1.59 (1.18, 2.14) Type of insurance coverage*Race/ethnicity Medicaid*Latino 0.40 (0.20, 0.81) 0.59 (0.44, 0.80) Medicaid*Asian 0.27 (0.11, 0.69) 0.62 (0.37, 1.05) Medicaid*Black 0.37 (0.17, 0.83) 0.55 (0.32, 0.94) Medicaid*Other 0.23 (0.08, 0.63) 0.77 (0.42, 1.38) Private coverage, Covered California*Latino 1.57 (0.36, 6.91) 0.84 (0.37, 1.88) Private coverage, Covered California*Asian 0.84 (0.08, 8.61) 1.12 (0.39, 3.19) Private coverage, Covered California*Black 1.00 (0.16, 6.34) 0.96 (0.29, 3.11) Private coverage, Covered California*Other 0.07 (0.01, 0.55) 0.56 (0.13, 2.48) Private coverage, off-exchange *Latino 0.64 (0.11, 3.78) 0.57 (0.29, 1.14) Private coverage, off-exchange*Asian 1.07 (0.18, 6.36) 0.66 (0.24, 1.86) Private coverage, off-exchange*Black 0.91 (0.15, 5.65) 0.36 (0.10, 1.26) Private coverage, off-exchange*Other 0.17 (0.00, 6.07) 0.49 (0.15, 1.61) Medicare and Medicaid*Latino 0.46 (0.14, 1.53) 0.59 (0.38, 0.91) Medicare and Medicaid*Asian 0.41 (0.08, 2.07) 0.52 (0.24, 1.12) Medicare and Medicaid*Black 0.51 (0.11, 2.50) 0.56 (0.31, 1.00) Medicare and Medicaid*Other 0.47 (0.11, 2.49) 1.26 (0.51, 3.13) Medicare alone or with other insurance*Latino 1.41 (0.47, 4.24) 0.70 (0.47, 1.06) Medicare alone or with other insurance*Asian 1.86 (0.49, 7.00) 1.07 (0.64, 1.80) Medicare alone or with other insurance*Black 2.20 (0.86, 5.51) 0.70 (0.42, 1.16) Medicare alone or with other insurance*Other 2.01 (0.54, 7.39) 1.11 (0.62, 2.00) Other public sponsored coverage*Latino 0.91 (0.06, 13.11) 1.13 (0.48, 2.66) Other public sponsored coverage*Asian 4.51 (0.20, 96.67) 1.75 (0.44, 6.89) Other public sponsored coverage*Black 0.79 (0.06, 10.79) 0.89 (0.27, 2.95) Other public sponsored coverage*Other 1.76 (0.14, 22.34) 0.60 (0.15, 2.43) Uninsured*Latino 0.45 (0.03, 6.38) 0.76 (0.44, 1.32) Uninsured*Asian 0.49 (0.04, 6.73) 0.67 (0.27, 1.66) Uninsured*Black 0.36 (0.02, 5.58) 0.80 (0.29, 2.16) Uninsured*Other 0.13 (0.01, 2.74) 0.68 (0.29, 1.57) Overall Test for Insurance Type* Race Interaction F P-Value F P-Value 1.52 0.0515 1.33 0.1354 AOR, adjusted odds ratio.
Significant associations denoted in bold, at P < .05.
95%CI = 95% confidence interval.
All models control for race, citizenship status, gender, educational attainment, age, household income, health status, diagnosis of chronic conditions, visual or hearing problem or impairment, survey year, and urban or rural residence.
- Table 4.
Logistic Regression Models for Odds of Delaying Medical Needed Medical Care or Prescription Drugs in the Past 12 Months, by Reason for Discrimination (n = 63,100)
Delayed or Did Not Get Needed Prescriptions in Past 12 Months Delayed or Did Not Get Needed Medical Care in Past 12 Months AOR 95%CI AOR 95%CI Reason for Discrimination Dissatisfaction with the health care system 1.66 (1.28, 2.15) 1.79 (1.38, 2.33) Race or skin color 1.69 (1.17, 2.46) 1.13 (0.80, 1.59) Age 1.30 (0.87, 1.96) 1.41 (1.00, 1.99) Way respondent speaks English or other barrier to communication 1.06 (0.56, 1.84) 1.97 (1.33, 2.92) Insurance status or type 0.92 (0.61, 1.39) 1.61 (1.11, 2.35) Income or education 1.35 (0.83, 2.20) 1.61 (0.96, 2.71) Any reason 1.75 (1.48, 2.07) 2.04 (1.70, 2.44) Significant associations denoted in bold, at P < .05.
AOR, adjusted odds ratio.
95%CI = 95% confidence interval.
All models control for race, citizenship status, gender, educational attainment, age, household income, health status, diagnosis of chronic conditions, visual or hearing problem or impairment, survey year, and urban or rural residence.
Each row in the table represents a separate model.
