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Area of Science:

  • Health Services Research
  • Health Equity Studies
  • Qualitative Health Research

Background:

  • Healthcare systems exhibit notable inequities, disproportionately affecting Black and immigrant communities.
  • Marginalization of these communities fuels distrust and exacerbates adverse health outcomes, widening the health gap.
  • Addressing disparities in patient care experiences is essential for achieving health equity.

Purpose of the Study:

  • To explore the lived experiences of patients from marginalized communities within the healthcare system.
  • To identify key themes contributing to healthcare inequities, including trust, discrimination, and social determinants of health.
  • To inform strategies for improving healthcare delivery and reducing disparities.

Main Methods:

  • A qualitative study employing purposive sampling in Central Brooklyn.
  • Conducted 10 focus groups (44 participants) and 18 key informant interviews.
  • Recruited 62 participants to gather in-depth perspectives on healthcare experiences.

Main Results:

  • Three primary themes emerged: Trust, Discrimination, and Social Determinants of Health (SDOHs).
  • Trust subthemes included confidence in professionals, provider empathy, and shared decision-making.
  • Discrimination subthemes involved racism, identity, and stigma; SDOHs highlighted barriers like housing and food insecurity.

Conclusions:

  • Patient interactions were often necessity-driven, not trust-based, highlighting systemic disconnects.
  • Discrimination and stigma amplified poor healthcare experiences for people of color.
  • Acknowledging and addressing SDOHs is vital for effective healthcare delivery and reducing inequities.