Beyond race: Impacts of non-racial perceived discrimination on health access and outcomes in New York City

Abstract

Background: I investigate the association of perceived discrimination based both on race and other attributes such as age, gender, and insurance status on self-reported health access and health outcomes in a diverse and densely populated metropolitan area.

Methods: Restricted data from the 2016 round of the New York City Community Health Survey was used to create prevalence estimates for both racial and non-racial discrimination. Logistic regression models were used to estimate the association of these discrimination measures with health access and health outcome variables.

Results: Among residents who perceived discrimination receiving health care during the previous year, 15% reported the reason behind such discrimination to race, while the rest chose other reasons. Among the non-race based categories, 34% reported the reason behind such discrimination to be insurance status, followed by other reasons (26.83%) and income (11.76%). Non-racial discrimination was significantly associated with the adjusted odds of not receiving care when needed (AOR = 6.96; CI: [5.00 9.70]), and seeking informal care (AOR = 2.24; CI: [1.13 4.48] respectively, after adjusting for insurance status, age, gender, marital status, race/ethnicity, nativity, and poverty. It was also associated with higher adjusted odds of reporting poor health (AOR = 2.49; CI: [1.65 3.75]) and being diagnosed with hypertension (AOR = 1.75; CI: [1.21 2.52]), and diabetes (AOR = 1.84; CI: [1.22 2.77]) respectively.

Conclusions: Perceived discrimination in health care exists in multiple forms. Non-racial discrimination was strongly associated with worse health access and outcomes, and such experiences may contribute to health disparities between different socioeconomic groups.

Fig 1. Prevalence and type of discrimination in health care.

(A) Trying to get health care treatment in the past 12 months, have you felt you were hassled, made to feel inferior, or discriminated against for any reason? (B) If experienced discrimination, what was the reason?.