Disparities in patient-centered communication for Black and Latino men in the U.S.: Cross-sectional results from the 2010 health and retirement study

Abstract

Background A lack of patient-centered communication (PCC) with health providers plays an important role in perpetuating disparities in health care outcomes and experiences for minority men. This study aimed to identify factors associated with any racial differences in the experience of PCC among Black and Latino men in a nationally representative sample. Methods We employed a cross-sectional analysis of four indicators of PCC representative of interactions with doctors and nurses from (N = 3082) non-Latino White, Latino, and Black males from the 2010 Health and Retirement Study (HRS) Core and the linked HRS Health Care Mail in Survey (HCMS). Men's mean age was 66.76 years. The primary independent variable was Race/Ethnicity (i.e. Black and Hispanic/Latino compared to white males) and covariates included age, education, marital status, insurance status, place of care, and selfrated health. Results Bivariate manova analyses revealed racial differences across each of the four facets of PCC experience such that non-Hispanic white men reported PC experiences most frequently followed by black then Hispanic/Latino men. Multivariate linear regressions predictive of PCC by race/ethnicity revealed that for Black men, fewer PCC experiences were predicted by discriminatory experiences, reporting fewer chronic conditions and a lack of insurance coverage. For Hispanic/Latino men, access to a provider proved key where not having a place of usual care solely predicted lower PCC frequency. Implications Researchers and health practitioners should continue to explore the impact of inadequate health care coverage, time-limited medical visits and implicit racial bias on medical

Examining Factors Associated with Utilization of Chaplains in the Acute Care Setting

“…Patient-centered hospital care requires providers to attend to patients' needs, values, and preferences through multidisciplinary efforts that prioritize the whole person (Aboumatar et al, 2015;Whittington et al, 2015). Without patient-centered approaches, health delivery systems reinforce existing disparities and exacerbate barriers to utilization (Mitchell & Perry, 2020). When patients do not receive adequate time with clinicians during clinical encounters they feel less heard and respected (Mitchell & Perry, 2020) which impacts adherence to preventative measures (Hammond et al, 2010), psychological well-being, and ultimately health outcomes (Buchmueller & Levy, 2020).…”

“…Without patient-centered approaches, health delivery systems reinforce existing disparities and exacerbate barriers to utilization (Mitchell & Perry, 2020). When patients do not receive adequate time with clinicians during clinical encounters they feel less heard and respected (Mitchell & Perry, 2020) which impacts adherence to preventative measures (Hammond et al, 2010), psychological well-being, and ultimately health outcomes (Buchmueller & Levy, 2020). Strong patient-centered care approaches require the integration of multiple disciplines to prevent the exacerbation of such disparities.…”

Peer Coaching to Improve Diabetes Self-Management Among Low-Income Black Veteran Men: A Mixed Methods Assessment of Enrollment and Engagement

“…It could be argued, however, that this communication style is especially relevant for interventions that target Black men due to existing disparities in patientcentered communication, which has been shown to promote health care engagement and outcomes. 56,57 Similar to autonomy-supportive communication, patient-centered communication strategies promote shared understanding, decision making, and power while working to understand people's unique perspectives and meet emotional and informational needs. 58 Existing disparities have a negative impact on Black men because they contribute to medical mistrust and delay preventative care, demonstrating the importance of incorporating this communication style into interventions for Black men.…”

Discrimination, trust, and withholding information from providers: Implications for missing data and inequity

“…The questions providers do and do not ask ( Hahn, 2009 ; Horne, 2006 ) and the ways they interact with patients ( Bugge et al, 2006 ) are important to patient disclosure, as these aspects of communication may discourage patients from disclosing information ( Stevenson, Cox, Britten, & Dundar, 2004 ). There is a considerable body of evidence of inequity in provider decision-making and communication styles by patient race, gender, and stigmatized conditions ( LaVeist, Nuru-Jeter, & Jones, 2003 ; Mitchell & Perry, 2020 ; N.; Trivedi, Moser, Breslau, & Chou, 2021 ; van Ryn & Fu, 2003 ). Thus, patient information sharing may be particularly sensitive to experiences of discrimination in the healthcare system.…”