Date of Award

8-2-2010

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Marcella Nunez-Smith,Mayur Desai

Second Advisor

Mayur Desai

Abstract

SOCIALLY-PERCEIVED RACE, PERCEIVED HEALTHCARE DISCRIMINATION AND PREVENTIVE HEALTH SERVICE UTILIZATION Tracy St. Louis MacIntosh, Mayur M. Desai, and Marcella Nunez-Smith. Department of Internal Medicine, Yale University School of Medicine, New Haven, CT. Self-identified racial/ethnic minorities are less likely to receive preventive care and more likely to report healthcare discrimination than whites. However, these outcomes may vary depending on whether racial/ethnic minorities are socially-perceived as minority versus white. We hypothesized that self-identified racial/ethnic minorities who believe they are socially-perceived as white have higher rates of preventive care and are less likely to report healthcare discrimination compared to minorities who believe they are socially-perceived as such. We conducted a cross-sectional analysis of the 2004 Behavioral Risk Factor Surveillance System. Respondents were categorized into 3 groups, defined by self-identified/socially-perceived race: Minority/Minority (n=6,837), Minority/White (n=929), and White/White (n=25,913). The Minority/Minority and Minority/White groups were equally likely to report having a physician (80.4% vs. 79.9%), yet Minority/White respondents were less likely to report experiencing healthcare discrimination (5.0% vs. 9.4%, p<0.0001). The Minority/White and White/White groups had similar rates for past-year influenza (69.7% vs. 72.5%) and pneumococcal (60.4% vs. 68.2%) vaccinations; corresponding rates were significantly lower among the Minority/Minority group (54.5% influenza and 48.2% pneumococcal, p-values<0.05). Minorities who are socially-perceived as minorities are equally likely to have a personal physician as those who are socially-perceived as white, but are less likely to receive preventive vaccinations and more likely to report healthcare discrimination.

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