Perception of Race and Utilization of Healthcare
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Date
2013-05
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The Ohio State University
Abstract
While several academic disciplines have begun to realize that individuals’ views of their racial makeup and social situation can have an effect on many of their actions, little work has been done to understand how characteristics of one’s racial group identity can specifically affect healthcare utilization decisions and patterns. Using data from the 2004 Behavioral Risk Factor Surveillance System (BRFSS) from across five states (n=25,750) as well as an online survey designed to better understand how perception of race can impact healthcare institution choices (n=300), this study explored how frequency of thoughts of race, racial group centrality, knowledge of past and current health disparities, trust in the healthcare system, and previous health-related discriminatory experiences may impact decisions to utilize healthcare. A racially stratified analysis of data extracted from the 2004 BRFSS data set, after adjusting for variables such as income, education level, and health care coverage, showed that the number of doctor visits was not impacted by frequency of thoughts of race in Whites, showed that a borderline significant relationship existed between the variables for Hispanic individuals, and showed that a significant relationship existed between the variables for Black individuals. Additionally, a statistically significant relationship was specifically discovered in Blacks with the poorest self-rated mental and general health status. A racially stratified analysis of the first experimental treatment within the online survey indicated that Blacks were more likely to have a preference for a hospital advertisement featuring Black healthcare workers, which was moderated by black centrality, trust in the healthcare system, belief that the Tuskegee Experiment could happen again, and belief that racial health disparities currently exist. No such statistically significant relationship was found for Whites. In analysis of the second experimental treatment in the online survey, no relationship was found for either race with regard to physician preference by racialized name. General trends from the survey indicate that both Blacks and Whites were equally as likely to have had a discriminatory healthcare experience and to have a similar level of trust in the healthcare system; however, Blacks were much more likely that Whites to believe that racial health disparities exist, to be knowledgeable about current health disparities, to have knowledge of the Tuskegee Experiment, and to believe that something like the Tuskegee Experiment could happen again. These results suggest that racial identity and perception of past and present mistreatment and disparities are important components in the health decision-making process for Black Americans but not necessarily for White Americans. This also suggests that more attention should be given to exploring how one’s identification with his or her race may influence the care he or she chooses to seek in the hopes of identifying policy and programming options that may equalize health access and outcomes across races.
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Keywords
Public Health, Racial Health Disparities, Minority Health, Health Advertisements