Perceived Discrimination and Use of Health Care Services in a North Carolina Population of Latino Immigrants

Keller, Sara C.; Silberberg, Mina; Hartmann, Katherine E.; Michener, J. Lloyd

doi:10.1891/1540-4153.8.1.4

Cited by 21 publications

(29 citation statements)

References 27 publications

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“…It is unknown if a lack of sufficient Spanish language services, turnover of providers at safety-net healthcare facilities, overbooked appointment schedules, or patients not requesting appointments with a specific provider were the causes. Perceived discrimination, both insurance-based and due to being Hispanic, was described, similar to findings of other studies with Hispanics in various regions of the U.S. (Calo et al, 2015; Han, Call, Pintor, Alarcon-Espinoza, & Simon, 2015; Keller et al, 2010; Reininger et al, 2014). Persons without insurance or having publically supported health insurance have reported greater difficulty getting a timely appointment and higher odds of forgoing needed care as compared to those with private insurance (Han et al, 2015).…”

Section: Discussionsupporting

confidence: 87%

“…Perceived poor patient-provider interactions have negatively impacted confianza , trust, with the healthcare team (Reininger et al, 2014; Schenker et al, 2010). Also, negative interactions with front office staff have been reported in previous studies with Hispanics contributing to feelings of disrespect, patient dissatisfaction, and perceived discrimination (Keller, Silberberg, Hartmann, & Michener, 2010; Tajeu et al, 2015). Patient-provider relationships built on respect, trust, and culturally competent care are critical to person-centered care (Hudon et al, 2012).…”

Section: Discussionmentioning

confidence: 77%

“…Nápoles et al 2012 had a similar finding with Spanish speaking older Hispanics in California describing feelings of discrimination and perceptions of receiving less culturally competent care from providers and office staff. Hispanics who reported perceived discrimination in healthcare settings indicated greater mistrust in healthcare providers, going without needed services, discontinuing important treatments, and dissatisfaction with services (Becerra et al, 2015; Calo et al, 2015; Keller et al, 2010). …”

Section: Discussionmentioning

confidence: 99%

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US Healthcare Experiences of Hispanic Patients with Diabetes and Family Members: A Qualitative Analysis

Amirehsani

Wallace

et al. 2017

Journal of Community Health Nursing

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Hispanics in the U.S. experience significant health disparities. Using focus groups conducted in Spanish, we explored the perspectives of 172 Hispanic adults regarding their healthcare experiences. Many participants were female (64.5%) and primarily from Mexico (80%). Four major qualitative themes emerged: 1) provide us with information, 2) want attentive and respectful relationships, 3) want better care, and 4) perceived discrimination. Suboptimal patient-provider interactions were described. Research is needed to explore interventions that address these issues. Incorporating person-centered care principles and practices such as clear and understandable communication, culturally competent care, and customer service skills may benefit provider interactions with Hispanics.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

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US Healthcare Experiences of Hispanic Patients with Diabetes and Family Members: A Qualitative Analysis

Amirehsani

Wallace

et al. 2017

Journal of Community Health Nursing

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“…Previous research has found insurance-based discrimination to be associated with delays in needed care and receipt of suboptimal care. 16,25 These findings highlight the need for both academic and policy attention to addressing insurance-based discrimination in health care settings. One intervention would be to foster positive relationships between providers and patients 45 at both the organizational and the state level.…”

Section: Policy Implicationsmentioning

confidence: 97%

“…16 In North Carolina, insurance-based discrimination was associated with an increased likelihood of going without needed care among Latino immigrants. 25 All research on insurance-based discrimination to date precedes the 2010 passage of the ACA. Given the push to promote access to health insurance and evidence that much of the increase in coverage is attributable to enrollment in public programs 26 (in which this form of discrimination is higher), understanding insurance-based discrimination and its association with access to care may provide important policy implications in the era of full implementation of the ACA.…”

mentioning

confidence: 99%

Reports of Insurance-Based Discrimination in Health Care and Its Association With Access to Care

et al. 2015

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Changes in Health Insurance Coverage Over Time by Immigration Status Among US Older Adults, 1992-2016

et al. 2020

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IMPORTANCEDisparities in health insurance coverage by immigration status are well documented; however, there are few data comparing long-term changes in insurance coverage between immigrant and nonimmigrant adults as they age into older adulthood. OBJECTIVE To compare longitudinal changes in insurance coverage over 24 years of follow-up between recent immigrant, early immigrant, and nonimmigrant adults in the US. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study used data from the nationally representative Health and Retirement Study. Data were collected biennially from 1992 to 2016. The population included community-dwelling US adults born between 1931 and 1941 and aged 51 to 61 years at baseline. Statistical analysis was performed from February 3, 2017, to January 10, 2020. EXPOSURES Participants were categorized as nonimmigrants (born in the US), early immigrants (immigrated to the US before the age of 18 years), and recent immigrants (immigrated to the US from the age of 18 years onward). MAIN OUTCOMES AND MEASURESSelf-reported data on public, employer, long-term care, and other private insurance were used to define any insurance coverage. Longitudinal changes in insurance coverage were examined over time by immigration status using generalized estimating equations accounting for inverse probability of attrition weights. The association between immigration status and continuous insurance coverage was also evaluated. RESULTSA total of 9691 participants were included (mean [SD] age, 56.0 [3.2] years; 5111 [52.6%] female). Nonimmigrants composed 90% (n = 8649) of the cohort; early immigrants, 2% (n = 201); and recent immigrants, 8% (n = 841). Insurance coverage increased from 68%, 83%, and 86% of recent immigrant, early immigrant, and nonimmigrant older adults, respectively, in 1992 to 97%, 100%, and 99% in 2016. After accounting for selective attrition, recent immigrants were 15% less likely than nonimmigrants to have any insurance at baseline (risk ratio, 0.85; 95% CI, 0.82-0.88), driven by lower rates of private insurance. However, disparities in insurance decreased incrementally over time and were eliminated, such that insurance coverage rates were similar between groups as participants attained Medicare age eligibility. Furthermore, recent immigrants were less likely than nonimmigrants to be continuously insured (risk ratio, 0.89; 95% CI, 0.85-0.94).CONCLUSIONS AND RELEVANCE Among community-dwelling adults who were not age eligible for Medicare, recent immigrants had lower rates of health insurance, but this disparity was eliminated over the 24-year follow-up period because of uptake of public insurance among all participants. (continued) Key Points Question Does health insurance coverage over time differ between recent immigrant, early immigrant, and nonimmigrant adults in the US? Findings In this cohort study of 9691 US adults, recent immigrants were 15% less likely than nonimmigrants to have insurance coverage at baseline, but this disparity was eliminated over the 24-year follow-up pe...

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Perceived Discrimination and Use of Health Care Services in a North Carolina Population of Latino Immigrants

Cited by 21 publications

References 27 publications

US Healthcare Experiences of Hispanic Patients with Diabetes and Family Members: A Qualitative Analysis

US Healthcare Experiences of Hispanic Patients with Diabetes and Family Members: A Qualitative Analysis

Reports of Insurance-Based Discrimination in Health Care and Its Association With Access to Care

Changes in Health Insurance Coverage Over Time by Immigration Status Among US Older Adults, 1992-2016

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