Discrimination and Health Care Utilization

by Janice C. Blanchard

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Abstract

Despite improvements in medical technology and increased availability of health care, blacks have continued to suffer excess mortality for a number of common health conditions. This dissertation examines the ways in which discrimination can affect health care utilization. Using data from the Commonwealth Fund 2001 Health Care Quality Survey, it focuses on key measures of perceived discrimination as well as measures of health care utilization. Minorities were significantly more likely than whites to report being treated with disrespect or being looked down upon in the patient-provider relationship. Persons who thought that they would have received better treatment if they were of a different race were significantly less likely to receive optimal chronic disease screening and more likely not to follow the doctor’s advice or put off care. Racial concordance of patient and provider did not affect whether a patient perceived being treated with respect in the patient-provider setting. While improving the numbers of minority providers in the health care setting is critical, the Commonwealth Fund data suggest that this is not the only pathway that must be addressed.

This document was submitted as a dissertation in December, 2005 in partial fulfillment of the requirements of the doctoral degree in public policy analysis at the Pardee RAND Graduate School. The faculty committee that supervised and approved the dissertation consisted of Jeannette Rogowski (Chair), Nicole Lurie, and Robert Brook.

This report is part of the RAND Corporation dissertation series. PRGS dissertations are produced by graduate fellows of the Pardee RAND Graduate School, the world's leading producer of Ph.D.'s in policy analysis. The dissertations are supervised, reviewed, and approved by a PRGS faculty committee overseeing each dissertation.

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