Health care barriers, racism, and intersectionality in Australia

Abstract

While racism has been shown to negatively affect health care quality, little is known about the extent to which racial discrimination works with and through gender, class, and sexuality to predict barriers to health care (e.g., perceived difficulty accessing health services). Additionally, most existing studies focus on racial disparities in the U.S. context, with few examining marginalized groups in other countries. To address these knowledge gaps, we analyze data from the 2014 Australian General Social Survey, a nationally representative survey of individuals aged 15 and older living in 12,932 private dwellings. Following an intersectional perspective, we estimate a series of multivariable logit regression models to assess three hypotheses: racial discrimination will be positively associated with perceived barriers to health care (H1); the effect of perceived racial discrimination will be particularly severe for women, sexual minorities, and low socio-economic status individuals (H2); and, in addition to racial discrimination, other forms of perceived discrimination will negatively impact perceived barriers to health care (H3). Findings show that perceptions of racial discrimination are significantly associated with perceived barriers to health care, though this relationship is not significantly stronger for low status groups. In addition, our analyses reveal that perceived racism and other forms of discrimination combine to predict perceived barriers to health care. Taken together, these results speak to the benefits of an intersectional approach for examining racial inequalities in perceived access to health care.

Incarcerated Aboriginal women’s experiences of accessing healthcare and the limitations of the ‘equal treatment’ principle

“…Previous research shows that Indigenous people experience disparate healthcare treatment and quality [68][69][70][71]. Our study provides further evidence that inequitable access to culturally safe healthcare and institutional racism reinforces and results in further health disparities and negative physical and mental health outcomes [72][73][74].…”

Intersectional equity in health care: assessing complex inequities in primary and secondary care utilization by gender and education in northern Sweden

“…Despite this recent interest for intersectionality in research on health equity, most examples of empirical research on intersectional inequities has focused on disparities in health outcomes rather than on health care services or utilization [ 33 – 35 ]. Bastos and colleagues [ 36 ] published one of the few studies on intersectionality in health care utilization and how it is patterned by racial disparities. Likewise, whereas multiple novel methodological approaches to analysing intersectional inequalities have been proposed in recent years [ 37 – 39 ], they concern assessment of health inequalities rather than health care inequities.…”

Mixed studies review of factors influencing receipt of pain treatment by injured black patients

“…Racial and ethnic disparities in healthcare are not a uniquely American problem. Disparate access to quality healthcare and racism in healthcare remain serious issues in South Africa, the United Kingdom, Canada, Brazil, Israel and Australia, among other nations (Ahmed et al, ; Bastos, Harnois, & Paradies, ; Burgard & Treiman, ; Chauhan et al, ; Saabneh, ; Salway et al, ). The unique racial and colonial histories of different countries influence racial disparities that persist today, however, the experiences of marginalized groups in one geographical area may mirror the experiences of populations in other parts of the world.…”