TY - JOUR
T1 - Discrimination in the United States
T2 - Experiences of black Americans
AU - Bleich, Sara N.
AU - Findling, Mary G.
AU - Casey, Logan S.
AU - Blendon, Robert J.
AU - Benson, John M.
AU - SteelFisher, Gillian K.
AU - Sayde, Justin M.
AU - Miller, Carolyn
N1 - Funding Information:
Joint Acknowledgement/Disclosure Statement : This work was supported by Grant #73713 from the Robert Wood Johnson Foundation. Dr SteelFisher's husband has done work for Eli Lilly in the past five years and has minority ownership in a company that does work for Eli Lilly. Some readers may wish to know all healthcare‐related financial relationships of the authors.
PY - 2019/12/1
Y1 - 2019/12/1
N2 - Objective: To examine experiences of racial discrimination among black adults in the United States, which broadly contribute to their poor health outcomes. Data Source and Study Design: Data come from a nationally representative, probability-based telephone survey including 802 non-Hispanic black and a comparison group of 902 non-Hispanic white US adults, conducted January–April 2017. Methods: We calculated the percent of blacks reporting discrimination in several domains, including health care. We used logistic regression to compare the black-white difference in odds of discrimination, and among blacks only to examine variation by socioeconomic status, gender, and neighborhood racial composition. Principal Findings: About one-third of blacks (32 percent) reported experiencing discrimination in clinical encounters, while 22 percent avoided seeking health care for themselves or family members due to anticipated discrimination. A majority of black adults reported experiencing discrimination in employment (57 percent in obtaining equal pay/promotions; 56 percent in applying for jobs), police interactions (60 percent reported being stopped/unfairly treated by police), and hearing microaggressions (52 percent) and racial slurs (51 percent). In adjusted models, blacks had significantly higher odds than whites of reporting discrimination in every domain. Among blacks, having a college degree was associated with higher odds of experiencing overall institutional discrimination. Conclusions: The extent of reported discrimination across several areas of life suggests a broad pattern of discrimination against blacks in America, beyond isolated experiences. Black-white disparities exist on nearly all dimensions of experiences with public and private institutions, including health care and the police. Evidence of systemic discrimination suggests a need for more active institutional interventions to address racism in policy and practice.
AB - Objective: To examine experiences of racial discrimination among black adults in the United States, which broadly contribute to their poor health outcomes. Data Source and Study Design: Data come from a nationally representative, probability-based telephone survey including 802 non-Hispanic black and a comparison group of 902 non-Hispanic white US adults, conducted January–April 2017. Methods: We calculated the percent of blacks reporting discrimination in several domains, including health care. We used logistic regression to compare the black-white difference in odds of discrimination, and among blacks only to examine variation by socioeconomic status, gender, and neighborhood racial composition. Principal Findings: About one-third of blacks (32 percent) reported experiencing discrimination in clinical encounters, while 22 percent avoided seeking health care for themselves or family members due to anticipated discrimination. A majority of black adults reported experiencing discrimination in employment (57 percent in obtaining equal pay/promotions; 56 percent in applying for jobs), police interactions (60 percent reported being stopped/unfairly treated by police), and hearing microaggressions (52 percent) and racial slurs (51 percent). In adjusted models, blacks had significantly higher odds than whites of reporting discrimination in every domain. Among blacks, having a college degree was associated with higher odds of experiencing overall institutional discrimination. Conclusions: The extent of reported discrimination across several areas of life suggests a broad pattern of discrimination against blacks in America, beyond isolated experiences. Black-white disparities exist on nearly all dimensions of experiences with public and private institutions, including health care and the police. Evidence of systemic discrimination suggests a need for more active institutional interventions to address racism in policy and practice.
KW - African Americans
KW - black Americans
KW - discrimination
KW - racial disparities in health and health care
KW - racism
KW - social determinants of health
KW - survey research
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U2 - 10.1111/1475-6773.13220
DO - 10.1111/1475-6773.13220
M3 - Article
C2 - 31663124
AN - SCOPUS:85074851096
VL - 54
SP - 1399
EP - 1408
JO - Health Services Research
JF - Health Services Research
SN - 0017-9124
IS - S2
ER -