Patient perspectives on routinely being asked about their race and ethnicity: Qualitative study in primary care

To understand patients' perspectives on responding to a question about their race and ethnicity in a primary care setting.

Qualitative study using semistructured individual interviews conducted between May and July 2016.

An academic family health team in Toronto, Ont, where collection of sociodemographic data has been routine since 2013.

Twenty-seven patients from 5 of the 6 clinic sites of the family health team, ranging in age, sex, educational background, and immigration status.

Semistructured interviews were conducted with patients who completed a sociodemographic questionnaire after registration for their medical appointment. Patients were asked whether responding to the question was difficult or uncomfortable, how they interpreted the term race and ethnicity, and what response options they considered. Interviews were audiorecorded, transcribed, and coded iteratively.

Patients did not report discomfort with responding to a question about race and ethnicity in their family doctor's office. Although many patients considered the question straightforward, some patients reported different interpretations of the question. For example, some thought the question about race and ethnicity related to parental origin or ancestry, whereas others considered the question to be about personal place of birth or upbringing. Many patients appreciated being able to select from a variety of specific response options, but this also posed a difficulty for patients who could not easily find an option that reflected their identity. Patients with mixed heritage experienced the most challenges selecting a response.

Patients attending a primary care clinic were not uncomfortable responding to a question about race and ethnicity. However, patients had different interpretations of what was being asked. Future research should explore perspectives of patients in other primary care settings and test different methods for collecting data about their race and ethnicity.