Perceived discrimination and adherence to medical care in a racially integrated community.

Full Abstract

BACKGROUND:
Past research indicates that access to health care and utilization of services varies by sociodemographic characteristics, but little is known about racial differences in health care utilization within racially integrated communities.

OBJECTIVE:
To determine whether perceived discrimination was associated with delays in seeking medical care and adherence to medical care recommendations among African Americans and whites living in a socioeconomically homogenous and racially integrated community.

DESIGN:
A cross-sectional analysis from the Exploring Health Disparities in Integrated Communities Study.

PARTICIPANTS:
Study participants include 1,408 African-American (59.3%) and white (40.7%) adults (> or =18 years) in Baltimore, Md.

MEASUREMENTS:
An interviewer-administered questionnaire was used to assess the associations of perceived discrimination with help-seeking behavior for and adherence to medical care.

RESULTS:
For both African Americans and whites, a report of 1-2 and >2 discrimination experiences in one's lifetime were associated with more medical care delays and nonadherence compared to those with no experiences after adjustment for need, enabling, and predisposing factors (odds ratio [OR] = 1.8, 2.6; OR = 2.2, 3.3, respectively; all P < .05). Results were similar for perceived discrimination occurring in the past year.

CONCLUSIONS:
Experiences with discrimination were associated with delays in seeking medical care and poor adherence to medical care recommendations INDEPENDENT OF NEED, ENABLING, AND PREDISPOSING FACTORS, INCLUDING MEDICAL MISTRUST; however, a prospective study is needed. Further research in this area should include exploration of other potential mechanisms for the association between perceived discrimination and health service utilization.

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Author information

Author/s: Casagrande, Sarah Stark (SS); Gary, Tiffany L (TL); LaVeist, Thomas A (TA); Gaskin, Darrell J (DJ); Cooper, Lisa A (LA);

Affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.

Grants: K24HL083113 (Agency:NHLBI NIH HHS) ; P60MD000214-01 (Agency:NCMHD NIH HHS)

Journal and publication information

Publication Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

Journal: Journal of general internal medicine : official journal of the Society for Research and Education in Primary Care Internal Medicine (J Gen Intern Med), published in United States. (Language: eng)

Reference: 2007-Mar; vol 22 (issue 3) : pp 389-95

Dates: Created 2007/03/14; Completed 2007/06/18; Revised 2008/11/20;

PMID: 17356974, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent
Adult
African Americans - ethnology
Aged
Cross-Sectional Studies
European Continental Ancestry Group - ethnology
Female
Health Services Accessibility

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