“We get double slammed!”: Healthcare experiences of perceived discrimination among low-income African-American women

Abstract

Background: On account of their racial/ethnic minority status, class, and gender, African-American women of low socioeconomic status are among the least privileged, underserved, and most marginalized groups in the United States. Generally, African Americans continue to experience poorer health outcomes, in which disparities have been attributed to socioeconomic inequities and structural racism. This objective of this study was to explore the lived experiences of low-income African-American women in interacting with the healthcare system and healthcare providers. Methods: Twenty-two in-depth one-on-one interviews were conducted with low-income African-American women. The audio-recorded interviews were transcribed verbatim. An inductive content analysis was performed, using an analytical software, Dedoose® to enabled hierarchical coding. Codes were grouped into categories which were further analyzed for similarities that led to the emergence of themes. Results: A key finding was the experience of discriminatory treatment. The three themes that emerged relevant to this category were (1) perceived discrimination based on race/ethnicity, (2) perceived discrimination based on socioeconomic status, and (3) stereotypical assumptions such as drug-seeking and having sexually transmitted diseases. Conclusion and Recommendations: Low-income African-American women experience less than satisfactory patient care, where participants attribute to their experience of being stereotyped and their perception of discrimination in the healthcare system and from providers. Patients’ experiences within the healthcare system have implications for their healthcare-seeking behaviors and treatment outcomes. Healthcare personnel and providers need to be more aware of the potential for implicit bias toward this population. Healthcare workforce training on culturally responsive patient care approaches and more community engagement will help providers better understand the context of patients from this population and more effectively meet their healthcare needs.

Patient and Provider Perspectives on Acceptability, Access, and Adherence to 17-Alpha-Hydroxyprogesterone Caproate for Preterm Birth Prevention

“…The type of communication patients receive during clinical encounters is associated with their overall health care experience. Studies have observed lower quality communication during health care visits among racial and ethnic minority patients than among white patients [34][35][36] and alarming racial biases in assessing and treating pain. 37 A growing body of literature [38][39][40][41][42][43] posits that addressing this issue is all the more important during the perinatal period, therefore, improving patient-provider relationships by way of tackling perceived discrimination and problematic communication encounters is a needed strategy to reduce racial disparities in maternity care and birth outcomes.…”

Transitional care innovation for Medicaid-insured individuals: early findings

“…19 In addition, low-income, individuals have repeatedly recounted experiences of discrimination based on socioeconomic and racial status during interactions with healthcare providers. 20 These experiences may result in avoidance of healthcare settings and paradoxically increase ED utilisation or avoidable hospitalisations due to inadequate management of chronic illnesses. 21 Persistent health inequities among Medicaid-insured individuals demand focused innovations that are centred in equity principles and bridge coordination and continuity between acute and community health providers.…”

“…The impact of marginalising conditions is heightened during the period of transition from hospital to home when individuals are required to obtain medications or durable medical equipment, schedule and access follow-up appointments and understand and execute treatment orders all while coping with competing economic needs 19. In addition, low-income, individuals have repeatedly recounted experiences of discrimination based on socioeconomic and racial status during interactions with healthcare providers 20. These experiences may result in avoidance of healthcare settings and paradoxically increase ED utilisation or avoidable hospitalisations due to inadequate management of chronic illnesses 21…”

Posición social y obesidad en población chilena: mediadores y moderadores psicológicos

“…Esto se evidencia en los hallazgos de este estudio, que pese a tener un tamaño de efecto pequeño pero significativo, indica que la PS podría asociarse con obesidad abdominal mediante una secuencia de relaciones que considera variables tales como la discriminación percibida, afectividad negativa y calidad de la dieta. Este resultado es consistente con estudios previos que advierten que personas con menor PS están mayormente expuestas a experiencias de discriminación (Okoro et al, 2020), las cuales generan mayores niveles de estrés (Urzúa et al, 2021) y síntomas depresivos (Qin et al, 2020), lo que a su vez, genera mayor consumo de comida chatarra (Agurs-Collins & Fuemmeler, 2011), influyendo finalmente en el aumento del perímetro de cintura (Mozaffarian, 2016). Pese a lo anterior, es importante considerar que este hallazgo no es conclusivo y debe ser investigado en otros estudios.…”