African American experiences in healthcare: "I always feel like I'm getting skipped over"

Abstract

Objective: Although African Americans perceive discrimination in health care settings, experience higher levels of medical mistrust compared with European Americans, and experience poorer communication with health care providers, little is known as to how these barriers to quality patient-provider relationships arise and manifest themselves. This study examined experiences of African American community members regarding these barriers and additionally explored participants' perspectives on race in the patient-provider relationship.

Methods: Focus groups were conducted as part of a study exploring participants' experiences and relationships in health care settings. Sixty African American adults were recruited through community settings and activities to participate in 1 of 9 focus groups segmented by gender. Transcripts were reviewed for content related to perceived discrimination, mistrust, poor communication, and race discordance. Themes providing insight into participants' subjective experience of these potential relationship barriers were derived through qualitative coding (using NVivo 10) and iterative discussion.

Results: Perceived discrimination arose when African American patients, particularly women, felt their symptoms or problems were discredited. Medical mistrust occurred when clinicians did not convey respect to patients, leaving patients to wonder whether their clinician's treatment was discriminatory or not. Poor communication arose when clinicians did not acknowledge patients' perspectives during interactions. Patients often viewed these actions as discriminatory.

Conclusions: African Americans experience poor communication with their health care providers, medical mistrust, and perceived discrimination when accessing health care in numerous and sometimes interrelated ways. The investigators recommend ways to reduce the experience of such barriers and to improve patient-provider relationships for African Americans in health care. (PsycINFO Database Record