Perceived discrimination among racial and ethnic minority drug users and the association with health care utilization

Abstract

People who use drugs (PWUDs) are at increased risk for several medical conditions, yet they delay seeking medical care and utilize emergency rooms (ERs) as their primary source of care. Limited research regarding perceived discrimination and PWUDs’ use of health care services exists. This study explores the association between interpersonal and institutional racial/ethnic and drug use discrimination in health care settings and health care utilization among respondents (N =192) recruited from Methadone Maintenance Treatment Programs (36%), HIV Primary Care Clinics (35%) and Syringe Exchange Programs (29%) in New York City (n = 88) and San Francisco (n = 104). The Kaiser Family Foundation Survey of Race, Ethnicity and Medical Care questionnaire was utilized to assess perceived institutional racial/ethnic and drug use discrimination.. Perceived institutional discrimination was examined across race/ethnicity and by regular use of ERs, having a regular doctor and consistent health insurance. Perceived interpersonal discrimination was examined by race/ethnicity. Perceived interpersonal drug use discrimination was the most common type of discrimination experienced in health care settings. Perceptions of institutional discrimination related to race/ethnicity and drug use among Non-Hispanic Whites did not significantly differ from Non-Hispanic Blacks or Hispanics. A perception of less frequent institutional racial/ethnic and drug use discrimination in health care settings was associated with increased odds of having a regular doctor. Awareness of perceived interpersonal and institutional discrimination in certain populations and the impact on health care service utilization should inform future intervention development to help reduce discrimination and improve health care utilization among PWUDs.

Elimination of HCV as a public health concern among people who inject drugs by 2030 – What will it take to get there?

“…Access to good quality healthcare should be a basic human right for any person, irrespective of whether they use drugs. In other settings, a lack of engagement in health services can stem from stigma and discrimination experienced from past encounters with the health system [103][104][105][106][107][108][109][110]. In one study from Thailand, 26% of PWID reported avoiding health services, with factors associated with avoidance of healthcare including experience of verbal abuse, having been refused medical care, and having experienced previous barriers to accessing health care [105].…”

Exclusão social vivenciada por pessoas dependentes de drogas e seus familiares: revisão integrativa da literature

“…Nesse sentido, o preconceito e o estigma são processos sociais similares que podem resultar em discriminação, estereótipos e rejeição social. Isso se deve ao fato de os transtornos mentais serem entreme-ados por estereótipos, mas são as pessoas envolvidas com a dependência de drogas que mais sofrem com tais processos (1,5,(11)(12)(13)(14) .…”

“…Tais questões culminam no estado pleno das desigualdades, denominado exclusão social. Caracterizado pelo processo acumulativo e multidimensional que separa e inferioriza as pessoas, os grupos, as comunidades e os territórios (4,12,15) . A exclusão social coexiste em vários tipos de fenômenos sociais, tais como o desemprego, a marginalidade, o preconceito e o pauperismo (17)(18) .…”

“…Este fato pode ser associado ao estigma, o qual reduz o usuário a um ser marginal e/ou com ausência de caráter. Desta forma, a droga foi considerada como fonte de estresse, sobrecarga e sofrimento para ambos os indivíduos (5,12,19) .…”

Availability of HIV and HCV On-Site Testing and Treatment at Syringe Service Programs in the United States

“…13 This may be attributed to generally less health care access in rural areas, 14 less access to SSPs due to distance or limited hours, 13 and greater fear of stigma in health care settings. 15 SSPs may serve to fill this gap by providing more culturally sensitive, stigma-free health services and connecting PWID to appropriate care.…”