Document Type
Article
Publication Date
Fall 9-19-2016
Journal / Book Title
Ethnicity & Health
Abstract
Objective
Surveys often ask respondents to assess discrimination in health care. Yet, patients’ responses to one type of widely used measure of discrimination (single-item, personally mediated) tend to reveal prevalence rates lower than observational studies would suggest. This study examines the meaning behind respondents’ closed-ended self-reports on this specific type of measure, paying special attention to the frameworks and references used within the medical setting.
Design
Twenty-nine respondents participated in this study. They were asked the widely used question: ‘Within the past 12 months when seeking health care do you feel your experiences were worse than, the same as, or better than people of other races?’ We then conducted qualitative interviews focusing on their chosen response and past experiences. Descriptive analyses focus on both the quantitative and qualitative data, including a comparison of conveyed perceived discrimination according to the different sources of data.
Results
To identify discrimination, respondents drew upon observations of dynamics in the waiting room or the health providers’ communication style. Our respondents were frequently ambivalent and uncertain about how their personal treatment in health care compared to people of other races. When participants were unable to make observable comparisons, they tended to assume equal treatment and report ‘same as’ in the close-ended reports.
Conclusion
Respondents’ responses to single-item, closed-ended questions may be influenced by characteristics specific to the health care realm. An emphasis on privacy and assumptions about the health care field (both authority and benevolence of providers) may limit opportunities for comparison and result in assumptions of racial parity in treatment.
DOI
10.1080/13557858.2016.1244659
MSU Digital Commons Citation
Lee, Chih-Yuan and Irby-Shasanmi, Amy, "‘Because I Don’t know’: uncertainty and ambiguity in closed-ended reports of perceived discrimination in US health care" (2016). Department of Public Health Scholarship and Creative Works. 128.
https://digitalcommons.montclair.edu/public-health-facpubs/128
Published Citation
Irby-Shasanmi, Amy, and Tamara GJ Leech. "‘Because I Don’t know’: uncertainty and ambiguity in closed-ended reports of perceived discrimination in US health care." Ethnicity & health 22, no. 5 (2017): 458-479. Harvard
Included in
Clinical Epidemiology Commons, Environmental Public Health Commons, Epidemiology Commons, Ethnic Studies Commons, Health Services Administration Commons, Health Services Research Commons, International and Area Studies Commons, International Public Health Commons, Other Public Health Commons, Patient Safety Commons, Public Health Education and Promotion Commons, Quantitative, Qualitative, Comparative, and Historical Methodologies Commons