Almost a quarter of Black parents experience unfair treatment in healthcare

Photo: Marko Geber/Getty Images

It's been long reported that Black patients and other members of racial/ethnic minority groups face discrimination or unfair treatment in healthcare. 

But a new Urban Institute study hones in specifically on minority parents, finding that 13% of parents, including parents of young children, reported they were treated or judged unfairly in healthcare settings in the past 12 months. 

Primarily this was because of their race or ethnicity, language, health insurance type, weight, income, disability or other characteristics.

The problem is worse among Black parents: More than one in five (22%) reported unfair treatment, a rate that was 10 percentage points higher than that of parents who are white, Hispanic/Latinx or belong to another group.

WHAT'S THE IMPACT

Urban Institute was spurred to examine the issue based on prior research showing that direct exposure to racism during childhood – and indirect exposure mediated through a parent's or caregiver's experiences – is associated with a range of adverse health effects, such as poor birth outcomes and worse child mental, socioemotional and general health.

Unfair treatment in clinical settings may therefore affect the health and well-being of both parents and children by causing "psychological and physiological stress responses," leading to disruptions in care and reductions in the quality of care, as well as fostering mistrust of healthcare providers during critical periods of childhood development.

Among the other findings are that 3% of all parents, and 9% of Black parents, reported that their children were treated or judged unfairly in healthcare settings in the past 12 months because of the parent's or child's race, ethnicity, country of origin or primary language.

Just over seven in 10 parents (71%) who experienced unfair treatment reported disruptions in their healthcare. About one-third (33%) took steps to express their dissatisfaction with how they were treated.

Meanwhile, four in 10 Black parents (40%) and 3 in 10 Hispanic/Latinx parents (30%) reported being concerned they or a family member will be treated or judged unfairly in healthcare settings in the future because of their or a family member's race, ethnicity or primary language.

Authors said changes in the healthcare system will be required to provide high-quality, respectful, culturally effective and evidence-based care to all children and their parents, including Black parents and parents of color.

One mechanism for doing so, they said, would be creating feedback loops for health insurance plans to document instances of unfair treatment by providers through patient satisfaction surveys and related data collection efforts. 

"Such efforts could document patient experiences and outcomes by race and ethnicity and establish criteria for determining whether providers and office staff members are qualified to provide culturally competent and effective evidence-based care as part of performance evaluations," according to the study.

THE LARGER TREND

Other disparities in healthcare are still prevalent. A JAMA Network Open study from earlier this year, for example, showed that a diagnosis claims-based algorithm used by payers to decide whether pediatric patients need to be taken to the emergency department will often bill Black and Hispanic patients more for care than their white counterparts.

This apparent inequity, authors said, is the unintended result of efforts to moderate cost growth in healthcare, including reducing wasteful spending and avoiding non-emergent ED visits. Among children, it has been estimated that up to 60% of ED visits may be avoided through better, more coordinated primary care.

In 2021 Project Impact was announced, a collaboration between clinical decision support system company VisualDx, the Skin of Color Society and the New England Journal of Medicine Group. Project IMPACT – Improving Medicine's Power to Address Care and Treatment – looks to bridge gaps in knowledge and improve outcomes for people of color.

Initially focusing on the field of dermatology, two goals are to raise awareness and adoption of educational and clinical resources, with an eye toward bolstering clinicians' ability to accurately diagnose disease in black and brown skin, and to improve health equity.
 

Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com