PT  - JOURNAL ARTICLE
AU  - Melissa L. Walls
AU  - John Gonzalez
AU  - Tanya Gladney
AU  - Emily Onello
TI  - Unconscious Biases: Racial Microaggressions in American Indian Health Care
AID  - 10.3122/jabfm.2015.02.140194
DP  - 2015 Mar 01
TA  - The Journal of the American Board of Family
                Medicine
PG  - 231--239
VI  - 28
IP  - 2
4099  - http://www.jabfm.org/content/28/2/231.short
4100  - http://www.jabfm.org/content/28/2/231.full
SO  - J Am Board Fam Med2015 Mar 01; 28
AB  - Purpose: This article reports on the prevalence and correlates of microaggressive experiences in health care settings reported by American Indian (AI) adults with type 2 diabetes mellitus (T2DM). Methods: This community-based participatory research project includes two AI reservation communities. Data were collected via in-person article-and-pencil survey interviews with 218 AI adults diagnosed with T2DM. Results: Greater than one third of the sample reported experiencing a microaggression in interactions with their health providers. Reports of microaggressions were correlated with self-reported history of heart attack, worse depressive symptoms, and prior-year hospitalization. Depressive symptom ratings seemed to account for some of the association between microaggressions and hospitalization (but not history of heart attack) in multivariate models. Conclusions: Microaggressive experiences undermine the ideals of patient-centered care and in this study were correlated with worse mental and physical health reports for AIs living with a chronic disease. Providers should be cognizant of these subtle, often unconscious forms of discrimination.