School of Biological Sciences, University of California, San Diego, La Jolla, CA
Daniel Sabater Minarim , Paul Riviere , Leah N. Deshler , Kylie M. Morgan , Elizabeth A. Duran , Matthew P. Banegas , Brent S. Rose
Background: Black men face a disproportionately higher risk of mortality from PC (prostate cancer), and disparities in healthcare access have been associated with these outcomes. Discrimination in healthcare settings can profoundly affect health outcomes, especially for populations with significant health conditions. This study examined the association between race/ethnicity and perceived healthcare discrimination among individuals diagnosed with PC. We hypothesized that (1) racial/ethnic minorities with PC would be more likely to perceive healthcare discrimination and that (2) such perceived discrimination is associated with self-reported poor health. Methods: Using the 'All of Us' database, we focused on patients diagnosed with PC. We analyzed variables related to perceptions of respect, courtesy, and service quality from healthcare providers, categorized by race. These perception variables were then grouped to form a composite measure of "perceived healthcare discrimination." Multivariable logistic regression was used to study the effects of race/ethnicity on perceived discrimination and its subsequent impact on self-reported health, adjusting for demographics. Results: In our PC patient cohort of 3,129 participants, the race breakdown was: White: 2665, Black or African American: 150, Hispanic/Latino: 98, Other: 171, Asian: 27, Multirace: 18; Gender: Male: 3008, Gender Diverse: 121. A substantial number of patients with PC reported experiencing discrimination in healthcare settings. According to updated data, Black or African American patients were more likely to perceive discrimination with an Odds Ratio (OR) of 5.20, p < 0.00. Hispanic/Latino patients had an OR of 1.53, p = 0.19, whereas Asians had an OR of 2.11, p = 0.17, and individuals of multiple races had an OR of 2.43, p = 0.16. In terms of health outcomes, patients who felt respected by their healthcare provider had an OR of 0.426 for reporting worse health, p < 0.01. Conversely, those who perceived a lack of respect had an OR of 2.346 for poor health, p < 0.01. Conclusions: Our findings enhance the understanding of the nuances of perceived healthcare discrimination among PC patients across racial and ethnic boundaries. Persistent racial differences underscore the need for systemic interventions in healthcare settings for PC patients. The identified negative experiences correlate with worsened health outcomes. Recognizing the instances of perceived healthcare discrimination in PC patients is paramount for elevating care quality and equity. Health systems are encouraged to take proactive measures in addressing these disparities, aiming for enhanced patient trust, improved communication, and superior outcomes.
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