Trends for Reported Discrimination in Health Care in a National Sample of Older Adults with Chronic Conditions

Nguyen, Thu T.; Vable, Anusha M.; Glymour, M. Maria; Nuru-Jeter, Amani

doi:10.1007/s11606-017-4209-5

Cited by 40 publications

(52 citation statements)

References 38 publications

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“…21 However, Black persons continue to report race as the most common reason for discrimination. 21 Historically, the interaction of AA women with the healthcare system has been characterized by racism at the structural and individual levels, 22 resulting in inadequate healthcare, suboptimal treatment, and often times preventable adverse outcomes. [23][24][25] The additional layers of socioeconomic disadvantage, historical trauma, and ongoing experiences of micro-aggressions make AA women one of the most vulnerable groups with regards to health.…”

Section: Perceived Racial/ethnic Discriminationmentioning

confidence: 99%

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

Okoro

Hillman

Cernasev

2020

Womens Health (Lond Engl)

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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.

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Section: Perceived Racial/ethnic Discriminationmentioning

confidence: 99%

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

Okoro

Hillman

Cernasev

2020

Womens Health (Lond Engl)

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“…However, previous evidence indicates that the specific type of stressor matters in determining the biological response to stress (i.e., integrated specificity) . AAs attribute the majority of their discrimination experiences to race . Moreover, AA women report racial discrimination as a particularly salient and chronic psychosocial stressor over their lifecourse, and as distinct from other forms of unfair treatment .…”

Section: Introductionmentioning

confidence: 99%

Racial discrimination, the superwoman schema, and allostatic load: exploring an integrative stress‐coping model among African American women

Allen

Wang

Chae

et al. 2019

Annals of the New York Academy of Sciences

106

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Racial discrimination has been linked to allostatic load (i.e., cumulative biological stress) among African American women. However, limited attention has been given to psychosocial processes involved in the stress response—critical for understanding biological pathways to health—in studies examining racial discrimination as a social determinant of health. We examined whether the superwoman schema (SWS), a multidimensional culture‐specific framework characterizing psychosocial responses to stress among African American women, modifies the association between racial discrimination and allostatic load. We used purposive sampling to recruit a community sample of African American women ages 30–50 from five San Francisco Bay Area counties (n = 208). Path analysis was used to test for interactions while accounting for the covariance among SWS subscales using both linear and quadratic models. Significant interactions were observed between racial discrimination and four of the five SWS subscales. Feeling obligated to present an image of strength and an obligation to suppress emotions were each protective whereas feeling an intense motivation to succeed and feeling an obligation to help others exacerbated the independent health risk associated with experiencing racial discrimination. Our findings affirm the need to consider individual variability in coping and potentially other psychosocial processes involved in the stress response process, and offer several insights that may help elucidate the mechanisms by which racial discrimination gets “under the skin.”

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“…These interventions are not only costly but there is also clear evidence of fragmented care across the services, increased polypharmacy and patients becoming lost in the system, either because of miscommunication itself, or because patients do not understand what they have to do to manage their care [3]. Compounding these issues, are those related to poor health literacy, geographical isolation, and cultural disparity, in addition to known institutional discrimination for patients who are deemed non-compliant or frequent presenters to hospital [4,5].…”

Section: Introductionmentioning

confidence: 99%

The use of telephone communication between nurse navigators and their patients

et al. 2020

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BackgroundHospitals and other health care providers frequently experience difficulties contacting patients and their carers who live remotely from the town where the health service is located. In 2016 Nurse Navigator positions were introduced into the health services by Queensland Health, to support and navigate the care of people with chronic and complex conditions. One hospital in Far North Queensland initiated an additional free telephone service to provide another means of communication for patients and carers with the NNs and for off-campus health professionals to obtain details about a patient utilising the service. Calls made between 7am and 10pm, seven days per week are answered by a nurse navigator. AimTo report utilisation of the service by navigated clients and remotely located clinicians compared to use of navigators' individual work numbers and direct health service numbers. We report the reason for calls to the free number and examine features of these calls. MethodsStatistical analysis examined the call reason, duration of calls, setting from where calls originated and stream of calls. Interactions between the reasons for calls and the features of calls, such as contact method, were examined. ResultsThe major reason for calls was clinical issues and the source of calls was primarily patients and carers. Clinical calls were longer in duration. Shorter calls were mainly non-clinical, PLOS ONE | https://doi.org/10.1371/journal.pone.made by a health professional. Setting for calls was not related to the reason. The most frequent number used was the individual mobile number of the NN, followed by the hospital landline. Although the free number was utilised by patients and carers, it was not the preferred option.

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Trends for Reported Discrimination in Health Care in a National Sample of Older Adults with Chronic Conditions

Cited by 40 publications

References 38 publications

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

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

Racial discrimination, the superwoman schema, and allostatic load: exploring an integrative stress‐coping model among African American women

The use of telephone communication between nurse navigators and their patients

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