Perceived Discrimination and Health Care Experiences among Latinos

1
Perceived Discrimination and Health Care
Experiences among Latinos

• Eva Maria Durazo, MPH
• School of Public Health Department of Community
  Health Sciences
• University of California Los Angeles

Preliminary Results
Background
Methods

• Doctors thought she was too, (pause), I didnt
  feel like she was being taken seriously. And they
  would get frustrated because I would need to be
  translating.
• -31 yr female, 2nd generation Mexican origin
• Unfair treatment in health care (others) 8 of 16
• Several more participants identified experiences
  of discrimination in health care for a family
  member or friend than they did for themselves.
• Discrimination was characterized by poor service
  and treatment. Language barriers were identified
  by the second generation children in reference to
  discriminatory experiences of their parents.
• Reasons given for the unfair treatment
• Unfair treatment/discrimination in other
  institutions 14 of 16
• Participants identified perceiving discrimination
  in education, work, housing, encounters with
  police, retail stores, and everyday interactions.
• For the second generation, discrimination is
  perceived as a common part of life. Most are able
  to articulate with certainty the reasons believed
  to be behind the discrimination.
• First generation immigrants mainly described
  specific events of discrimination. Few
  characterized discrimination as a daily
  experience.
• A veces es cuando discriminan porque tal vez
  dicen que no lo merecemos y no somos personas de
  que tenemos derecho a tener un seguro medico
  porque simplemente no somos nacido aquí. -38 yr
  female, Guatemala
• (Sometimes thats when they discriminate because
  they might say we dont deserve it and we dont
  have a right to health insurance simply because
  we were not born here.)
• All participants spoke more freely about
  stereotypes and discrimination against Latinos
  when referring to Latinos in general terms.

• Perceived discrimination is a factor in racial
  health disparities.
• Discrimination in health care affects access and
  behavior, resulting in underutilization or delay
  of care and lack of follow up by patients.
• Prejudices by a provider may influence the
  quality of care and treatment.
• Institutional discrimination in health care
  affects availability of resources and access to
  care for minority populations.
• Discrimination among the Latino population.
• Studies are beginning to examine various
  racial/ethnic groups with potentially different
  experiences from those of African-Americans.
• Few studies have looked at how Latinos perceive
  discrimination, which can have implications in
  the measurement of discrimination.
• Research has demonstrated that U.S. born Latinos
  and immigrant Latinos that have lived in the
  U.S. longer report higher rates of perceived
  discrimination.

• Data Collection
• Open-ended interviews with Latinos in the Los
  Angeles area who had visited a physician in the
  past year.
• Interviews in Spanish and English.
• Recruitment Strategies
• Snowball sampling
• Flyers at community clinics
• In person at ethnic markets, churches, community
  centers
• Data Analysis
• Interviews reviewed and common themes
  identified.
• Transcription and further analysis in progress.
• Sample
• First generation immigrant respondents from
  Mexico (3), Central America (7), and South
  America (1).
• Second generation born in the U.S. with parents
  originating from Mexico (3), Nicaragua (1), and
  El Salvador (1).

Research Question

• The purpose of this study is to explore the
  experiences and perception of discrimination in
  health care and other institutions among Latinos
  in the Los Angeles area.
• What are Latinos perception of discrimination in
  the health care system?
• Identify the type of experiences
• Identify the reasons believed to be responsible
  for the discrimination
• Identify how experiences vary by demographic
  characteristics

Discussion
Preliminary Results

• Discrimination in health care is difficult to
  identify. Few participants perceived unfair
  treatment in personal experiences with their
  medical providers.
• Interviews suggest that those with a higher
  education, regardless of generation, more often
  perceive differences in health care treatment.
• Institutional discrimination in health care may
  not translate into individual perceptions of
  discrimination however, the impact of lack of
  insurance and limited resources is apparent in
  participants interactions with health care.
• Discrimination in health care is conceptualized
  differently from everyday experiences of
  discrimination. There is more ambiguity in how
  people report unfair treatment.
• Further research is needed to understand if
  discrimination scales used in a Latino population
  effectively capture perceived discrimination in
  health care.
• The author thanks Steven P. Wallace, the Venice
  Family Clinic, and UCLAs Graduate Division

• No vuelvo ir a ninguna clínica free, porque no
  hay razón para que lo maltraten a uno. Sera
  porque somos Latinas, no se, no se. -59 yr
  female, Nicaragua
• (I wont go back to any free clinic because
  there is no reason for them to treat us badly.
  Maybe its because we are Latinas, I dont know,
  I dont know)
• Unfair treatment in health care (self) 6 of 16
• Few identified personal experiences with
  discrimination in health care.
• Of those that did, discrimination was mainly
  characterized as poor service, denial or delay of
  care, rudeness, and differential treatment.
• Reasons given for the unfair treatment

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