Everyday Discrimination and Health Care Utilization Among US Adults

Area of Science:

• Public Health
• Health Services Research
• Social Determinants of Health

Background:

• Everyday discrimination, characterized by subtle slights and unfair treatment, is recognized for its adverse health effects.
• However, its specific impact on health care utilization patterns remains inadequately understood.

Purpose of the Study:

• To investigate the association between everyday discrimination and health care use among adults in the United States.
• To quantify the relationship between discrimination experiences and various health care access and utilization metrics.

Main Methods:

• A cross-sectional study analyzed data from 27,384 National Health Interview Survey respondents (aged 18+).
• The Everyday Discrimination Scale (EDS) measured discrimination, with scores ranging from 0-20.
• Survey-weighted logistic regression models estimated adjusted odds ratios (AORs) for associations between EDS scores and health care outcomes, controlling for covariates.

Main Results:

• Higher everyday discrimination scores correlated with increased odds of cost-related barriers to medical care and prescription medications.
• Increased discrimination was associated with greater utilization of emergency department and urgent care visits.
• Conversely, higher discrimination scores were linked to lower odds of physician and dental visits, as well as reduced engagement in cholesterol testing and diabetes screening.

Conclusions:

• This study demonstrates a significant association between higher levels of everyday discrimination and increased reliance on emergency services, alongside decreased use of preventive care.
• Interventions targeting interpersonal and structural discrimination, such as culturally responsive care and implicit bias training, are vital.
• Addressing discrimination is essential to mitigate its negative impact on health care utilization and overall health outcomes.