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Perceived Discrimination in Health Care and Use of Preventive Health Services

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Abstract

Objective

To examine the relationship between perceived discrimination and preventive health care utilization.

Design and Participants

Cross-sectional analysis using the 2004 Behavioral Risk Factor Surveillance System “Reactions to Race” module (N = 28,839).

Measurements

Outcomes were self-reported utilization of seven preventive health services. Predictors included perceived negative and positive racial discrimination (vs. none) while seeking health care in the past year. Multivariable models adjusted for additional patient characteristics.

Main Results

In unadjusted models, negative discrimination was significantly associated with less utilization of mammogram, pap test, PSA test, blood stool test, and sigmoidoscopy/colonoscopy (ORs = 0.53–0.73, p < .05), but not flu or pneumococcal vaccines (ORs = 0.76 and 0.84). Positive discrimination was significantly associated with more utilization of all services (ORs = 1.29–1.58, p < .05) except pap test (OR = 0.94). In adjusted models, neither negative nor positive discrimination was predictive of utilization, except for PSA test (positive discrimination OR = 1.33, p < .05).

Conclusions

Perceived racial discrimination in health care does not independently predict preventive health care utilization.

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Acknowledgment

Dr. Hausmann was supported by a VA Health Services Research and Development Career Development Award (RCD 06-287). Dr. Ibrahim is the recipient of a VA Health Services Research and Development Award and the Harold Amos Robert Wood Johnson Scholar Award. Dr. Ibrahim is also supported by a K24 Award (1K24AR055259-01) from the National Institutes of Musculoskeletal and Skin Disorders. This publication was also made possible by Grant Number UL1 RR024153 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR, NIH, or the VA. Information on NCRR is available at http://www.ncrr.nih.gov/. Information on Re-engineering the Clinical Research Enterprise can be obtained from http://nihroadmap.nih.gov/clinicalresearch/overview-translational.asp.

Conflict of Interest

None disclosed.

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Corresponding author

Correspondence to Leslie R. M. Hausmann PhD.

Appendix

Appendix

APPENDIX A Association of Perceived Discrimination with Obtaining Flu and Pneumococcal Vaccinations, Adjusted for Covariates
APPENDIX B Association of Perceived Discrimination with Obtaining Screenings for Breast, Cervical, and Prostate Cancer, Adjusted for Covariates
APPENDIX C Association of Perceived Discrimination with Obtaining Screenings for Colon Cancer, Adjusted for Covariates

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Hausmann, L.R.M., Jeong, K., Bost, J.E. et al. Perceived Discrimination in Health Care and Use of Preventive Health Services. J GEN INTERN MED 23, 1679–1684 (2008). https://doi.org/10.1007/s11606-008-0730-x

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  • DOI: https://doi.org/10.1007/s11606-008-0730-x

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