Differences in Health Care Access and Satisfaction Across Intersections of Race/Ethnicity and Sexual Identity

Abstract

PurposeRacial/ethnic and sexual minorities experience numerous health disparities compared with their White and heterosexual counterparts, which may be exacerbated when these social identities intersect. The authors tested for differences in health care access and satisfaction across intersections of sexual identity and race/ethnicity. MethodA cross-sectional secondary data analysis of the 2012-2018 waves of the Association of American Medical Colleges biannual online Consumer Survey of Health Care Access was conducted. This survey captures a national sample of U.S. adults who reported needing health care in the past 12 months. The analytic sample included 29,628 participants. Sixteen possible combinations of sexual identity and race/ ethnicity were examined. Health care access and satisfaction were measured with 10 items and an index created from these items. Cumulative prevalence ratios (PRs) for the index and PRs across sexual identity, both individually and in combination with race/ethnicity, for each health care access and satisfaction item were generated.

Sexually Transmitted Infections Diagnosed Among Sexual and Gender Minority Communities During the First 11 Months of the COVID-19 Pandemic in Midwest and Southern Cities in the United States

“…4 Decreased access to STI testing and sexual health services among Hispanic MSM due to the pandemic may exacerbate existent health care access disparities. 30 The pandemic experience of these self-selected persons in these 5 cities may be different than a population-based sample and may be different in other regions of the country. It is a strength that these data come from both mid-sized and large metro areas in noncoastal cities.…”

“…During the pandemic, California surveillance data indicated that one of the largest declines in STI case reporting occurred in Hispanic persons with fewer cases of chlamydia, gonorrhea, nonprimary/nonsecondary syphilis, and unknown/late syphilis cases reported in the first half of 2020 compared with the same time period in 2019 4 . Decreased access to STI testing and sexual health services among Hispanic MSM due to the pandemic may exacerbate existent health care access disparities 30 …”

Eliminating health care inequities through strengthening access to care

“…Intersectionality, increasingly recognized as an important tool for health equity research, considers individuals with multiple marginalized identities who are subject to interactive mechanisms of oppression. 3,4,58,[62][63][64][65] There is limited consensus on best practices in education and training for providers to gain competency in structural racism, racial biases, intersectionality, and how these biases contribute to downstream health inequities. Research demonstrates that health systems and the providers within the systems espouse egalitarian views but concurrently manifest racial biases, which are associated with differential treatment, lower patient satisfaction, and ultimately delays in seeking care.…”

Race, Gender, Sexuality, and the Match: A Trainee’s Call to Diversify the Electronic Residency Application Service Statistics

“…Currently, disparities in health care for gender and sexual minorities remains a pressing topic. 3 However, most application services and diversity reports fail to recognize these variables as elements of diversity. The importance of physicians being representative of the population remains true for gender and sexual minorities.…”