Objective To examine reported experiences of discrimination against lesbian, gay, bisexual, transgender, and queer (LGBTQ) adults in the United States, which broadly contribute to poor health outcomes. Data Source and Study Design Data came from a national, probability‐based telephone survey of US adults, including 489 LGBTQ adults (282 non‐Hispanic whites and 201 racial/ethnic minorities), conducted January‐April 2017. Methods We calculated the percentages of LGBTQ adults reporting experiences of discrimination in health care and several other domains related to their sexual orientation and, for transgender adults, gender identity. We report these results overall, by race/ethnicity, and among transgender adults only. We used multivariable models to estimate adjusted odds of discrimination between racial/ethnic minority and white LGBTQ respondents. Principal Findings Experiences of interpersonal discrimination were common for LGBTQ adults, including slurs (57 percent), microaggressions (53 percent), sexual harassment (51 percent), violence (51 percent), and harassment regarding bathroom use (34 percent). More than one in six LGBTQ adults also reported avoiding health care due to anticipated discrimination (18 percent), including 22 percent of transgender adults, while 16 percent of LGBTQ adults reported discrimination in health care encounters. LGBTQ racial/ethnic minorities had statistically significantly higher odds than whites in reporting discrimination based on their LGBTQ identity when applying for jobs, when trying to vote or participate in politics, and interacting with the legal system Conclusions Discrimination is widely experienced by LGBTQ adults across health care and other domains, especially among racial/ethnic minorities. Policy and programmatic efforts are needed to reduce these negative experiences and their health impact on sexual and/or gender minority adults, particularly those who experience compounded forms of discrimination.

The coronavirus disease 2019 (COVID-19) pandemic has created unprecedented challenges to providing medical care for patients with conditions other than COVID-19 in the US. 1 While lack of health insurance and other cost-associated barriers have long been considered driving forces preventing healthcare access in the US prior to this pandemic, 2-4 other major barriers may have emerged during this extraordinary period. We reviewed several nationally representative public opinion polls that we and others have conducted during the COVID-19 pandemic to examine whether households with serious medical problems were able to get care they needed during this time.Among those unable to get care, we also assessed whether it was because of financial reasons (including insurance) or other issues. Delayed Medical Care Widely Reported During the COVID-19 PandemicDelayed care has been widely reported during the COVID-19 pandemic, both for perceived serious medical issues and all types of medical care generally. Between March and August, our "Impact of

Objective To examine experiences of racial discrimination among Asian Americans, which broadly contribute to poor health outcomes. Data Source and Study Design Data come from a nationally representative, probability‐based telephone survey, including 500 Asian and a comparison group of 902 white US adults, conducted January to April 2017. Methods We calculated the percent of Asian Americans reporting discrimination in several domains, including health care. We used logistic regression to compare the Asian‐white difference in odds of discrimination, and among Asians only to examine variation by geographic heritage group (South Asian versus East Asian) and gender. Principal Findings 13 percent of Asians reported discrimination in healthcare encounters. At least one in four adults reported experiencing discrimination in employment (27 percent job applications, 25 percent equal pay/promotions); housing (25 percent); and interpersonal interactions (35 percent microaggressions, 32 percent racial slurs). In unadjusted models, East and South Asians were more likely than whites to report experiences of institutional discrimination, and South Asians were more likely than whites to report microaggressions. In adjusted models, Asians had higher odds than whites of reporting avoiding health care due to discrimination concerns and also when obtaining housing. Conclusions Asians in the United States experience discrimination interpersonally and across many institutional settings, including housing and health care. South Asians may be especially vulnerable to forms of institutional discrimination and microaggressions. These results illustrate a need for greater investigation into the unique experiences of Asian subgroups and greater protections for groups at higher risk of discrimination, within health care and beyond.

Objective To examine experiences of racial discrimination among black adults in the United States, which broadly contribute to their poor health outcomes. Data Source and Study Design Data come from a nationally representative, probability‐based telephone survey including 802 non‐Hispanic black and a comparison group of 902 non‐Hispanic white US adults, conducted January–April 2017. Methods We calculated the percent of blacks reporting discrimination in several domains, including health care. We used logistic regression to compare the black‐white difference in odds of discrimination, and among blacks only to examine variation by socioeconomic status, gender, and neighborhood racial composition. Principal Findings About one‐third of blacks (32 percent) reported experiencing discrimination in clinical encounters, while 22 percent avoided seeking health care for themselves or family members due to anticipated discrimination. A majority of black adults reported experiencing discrimination in employment (57 percent in obtaining equal pay/promotions; 56 percent in applying for jobs), police interactions (60 percent reported being stopped/unfairly treated by police), and hearing microaggressions (52 percent) and racial slurs (51 percent). In adjusted models, blacks had significantly higher odds than whites of reporting discrimination in every domain. Among blacks, having a college degree was associated with higher odds of experiencing overall institutional discrimination. Conclusions The extent of reported discrimination across several areas of life suggests a broad pattern of discrimination against blacks in America, beyond isolated experiences. Black‐white disparities exist on nearly all dimensions of experiences with public and private institutions, including health care and the police. Evidence of systemic discrimination suggests a need for more active institutional interventions to address racism in policy and practice.

Objective To examine reported racial discrimination and harassment against Native Americans, which broadly contribute to poor health outcomes. Data Source and Study Design Data come from a nationally representative, probability‐based telephone survey including 342 Native American and 902 white US adults, conducted January‐April 2017. Methods We calculated the percent of Native Americans reporting discrimination in several domains, including health care. We used logistic regression to compare the Native American‐white difference in odds of discrimination and conducted exploratory analyses among Native Americans only to examine variation by socioeconomic and geographic/neighborhood characteristics. Principal Findings More than one in five Native Americans (23 percent) reported experiencing discrimination in clinical encounters, while 15 percent avoided seeking health care for themselves or family members due to anticipated discrimination. A notable share of Native Americans also reported they or family members have experienced violence (38 percent) or have been threatened or harassed (34 percent). In adjusted models, Native Americans had higher odds than whites of reporting discrimination across several domains, including health care and interactions with the police/courts. In exploratory analyses, the association between geographic/neighborhood characteristics and discrimination among Native Americans was mixed. Conclusions Discrimination and harassment are widely reported by Native Americans across multiple domains of their lives, regardless of geographic or neighborhood context. Native Americans report major disparities compared to whites in fair treatment by institutions, particularly with health care and police/courts. Results suggest modern forms of discrimination and harassment against Native Americans are systemic and untreated problems.