Health care utilization by ethnic minority populations: a narrative review and secondary data analysis

Abstract


 Background: Ethnic minority populations have lower rates of healthcare utilization than ethnic majority populations. 
 Purpose: This narrative review and secondary data analysis examines the factors inhibiting healthcare utilization in ethnic minority populations around the world and the associations between healthcare utilization factors and ethnic minority status in Western Guinea. 
 Method: A narrative review was conducted using 18 studies which examined health care utilization by ethnic minority populations in Bangladesh, India, Vietnam, China, Australia, Peru, Guatemala, Mexico, and Uganda. Secondary data analysis was conducted using Demographic and Health Surveys (DHS) data collected in Indonesia in 2017, with the use of migration status as a proxy for ethnic minority status in Western Guinea. 
 Results: There are four prominent factors which impacted healthcare utilization in the reviewed populations: financial access to health services, physical access to health services, the behavior and cultural competency of health service providers, and the quality of care provided. These trends are apparent in Western Guinea as well – there was a significant association (p = 0.00) between problems getting money for treatment and ethnic minority status and minority populations were more likely to seek less skilled care than majority populations. 
 Conclusion: Barriers to healthcare utilization operate systemically and reproductively to force ethnic minority populations into a state of lower socioeconomic status and health outcomes. The incorporation of anti-racist foundations in health service provision is necessary to ensure the right to health for ethnic minority populations and for the successful fulfillment of the third Sustainable Development Goal (SDG).

Overlooked and Damaging Impact of Structural Racism and Implicit Bias on US Health Care

“…5 In addition to factors aforementioned, other specific influences on cancer outcomes include work and environmental conditions (related to disproportionate exposure to carcinogens) and how health care is valued and utilized differently by certain groups. 6,7 The unfortunate result is disparities in access to preventive services and programs, leading to delayed screening and later-stage diagnosis. [8][9][10][11][12] Further complicated by the lack of representation of racial and ethnic minorities in clinical trials and the high cost of cancer care, many patients often receive lower-quality care because they do not have access to appropriate treatment options or lack the appropriate resources for supportive and palliative care.…”

“…Structural racism and implicit bias impact people with cancer across the cancer care continuum contributing to disproportionate disparities in cancer incidence and mortality rates among racial and ethnic groups and other marginalized populations 5 . In addition to factors aforementioned, other specific influences on cancer outcomes include work and environmental conditions (related to disproportionate exposure to carcinogens) and how health care is valued and utilized differently by certain groups 6,7 . The unfortunate result is disparities in access to preventive services and programs, leading to delayed screening and later-stage diagnosis 8–12 .…”