• Posted December 6, 2023

Minorities Expect and Prepare for Unfair Health Care, Survey Shows

Few people look forward to doctor visits, but a new survey shows that many minorities feel a deep sense of dread.

Some even try to dress especially well for their visit, to try and ward off the possibility they'll face insults or unfair care.

The new poll, conducted by health policy research group KFF, found 3 in 5 Black respondents prepare this way for a medical visit.

"It's exhausting,"survey respondent Christine Wright told the Associated Press.

The 60-year-old Black woman said she's faced years of discrimination, including a racial slur once from a nurse. After being diagnosed with breast cancer in 2017, she has finally found a doctor she trusts. But she noted she still makes sure to dress well for any medical appointments, putting on jewelry, a nice coat and making sure her hair is done.

She is not the only minority patient to feel this way.

The poll found that 55% of Black respondents said they believe they must be careful about their appearance to get fair treatment in doctor's offices. That's similar to the rate for Hispanic and Alaska Native patients -- and nearly double the rate for white patients, the poll found.

Meanwhile, nearly 30% of Black respondents said they prepare to be insulted, also about double the rate for white patients. The survey was conducted June 6 -- Aug. 14 online and by telephone among a nationally representative sample of 6,292 U.S. adults.

"While there have been efforts in health care for decades to document disparities and advance health equity, this survey shows the impact racism and discrimination continue to have on people's health care experiences,"KFF President and CEO Drew Altman said in a news release announcing the survey results. "And people in the survey reported that racism and discrimination have affected not only the care they get, but also their health and well-being,"

Dr. Allison Bryant, an obstetrician at Massachusetts General Hospital who was not involved in the survey, said the results weren't surprising.

Bryant, who serves as her hospital system's associate chief health equity officer, said she has heard similar stories from minority patients and seen it in her hospital's patient satisfaction data. Not only that, Bryant said she lives the experience herself as a Black woman, often double-checking she has her ID or wedding ring visible to ward off assumptions from others.

"I think everybody experiences that to some extent,"Bryant told the AP. "But I understand why it's more exaggerated in individuals of color, who have a legacy of not being treated well."

Still, the behavior can influence critical interactions between a doctor and patient.

If you think someone may treat you badly you may be more tense, you may not speak properly, Bryant said. "There are deep harms that are associated with this that go beyond what it might look like at the surface, which is like, 'I put on some high heels and I put on some lipstick,'"she noted.

Even though high numbers of minorities polled said they prepare for insults or feel their appearance can influence how they are treated at the doctor, 93% said they have not been treated unfairly or with disrespect in a health care setting because of their race or ethnic background in the past three years.

But there were still wide differences seen among racial groups. Asians and Hispanics were three times more likely to say they've been treated badly in a health care setting because of their race than white respondents, while Black respondents were six times more likely.

"The consequences in health care are really striking and very frightening, honestly, to understand what people need to do to be taken seriously, to be seen as a whole person,"Bryant said. "I think these data really speak to that."

More information

The American Medical Association has more on racial disparities in health care.

SOURCE: KFF, poll, Dec. 5, 2023; Associated Press