BACKGROUND: Access to health care varies according to a person’s race and ethnicity. Delaying treatment is one measure of access with
important health consequences.
OBJECTIVE: Determine whether perceptions of unfair treatment because of race or ethnicity are associated with reported treatment delays,
controlling for economic constraints, self-reported health, depression, and demographics.
DESIGN: Cross-sectional, observational study.
PARTICIPANTS: A randomly selected community sample of 181 blacks, 148 Latinos, and 193 whites in Durham County, NC.
MEASUREMENTS: A phone survey conducted in 2002 to assess discrimination, trust in medical care, quality of care, and access to care. Treatment
delays were measured by whether or not a person reported delaying or forgoing filling a prescription and delaying or forgoing
having a medical test/treatment in the past 12 months. Perceived discrimination was measured as unfair treatment in health
care and as racism in local health care institutions.
RESULTS: The odds of delaying filling prescriptions were significantly higher (odds ratio (OR)=2.02) for persons who perceived unfair
treatment, whereas the odds of delaying tests or treatments were significantly higher (OR=2.42) for persons who thought racism
was a problem in health care locally. People with self-reported depression and people who reported not working had greater
odds of delaying both types of care.
CONCLUSIONS: A prospective cohort study with both personal and macro measures of discrimination, as well as more refined measures of treatment
delays, would help us better understand the relationship between perceived discrimination and treatment delays.
Key words perceived discrimination - perceived racism - delay of treatment - pharmacy prescriptions - African American - black - Latino
The authors have no conflicts of interest to report.
Presented at the Annual Research Meeting, Academy for Health Care Policy and Research, Session on Disparities in Primary Care,
San Diego, CA, June 7, 2004.
The survey development and administration was supported by a grant from the Duke Endowment Foundation. The views expressed
in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.