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Perceived Racial Discrimination in Health Care Found to be Low and Similar among Veterans and Non-Veterans


  • Overall, rates of perceived racial discrimination in healthcare were low and barely differed between Veterans (3.4%) and non-Veterans (3.5%).
  • Rates of perceived racial discrimination were equally prevalent among Veterans who used the Veterans Affairs healthcare system and those who did not.
  • A sub-sample of Veterans who received all of their care within VA were twice as likely to report perceptions of racial discrimination; however, after controlling for patient characteristics (e.g., health status, socioeconomics), this difference was eliminated.
  • Veterans and non-Veterans differed significantly on nearly all background characteristics. For example, Veterans were more likely than non-Veterans to be white (84.5% vs. 79.3%), male (93.1% vs. 40.6%), and to have healthcare coverage (90.8% vs. 84.1%). Veterans also were significantly older: 32.5% of Veterans and 13.5% of non-Veterans were older than 65 years.

There is strong and consistent evidence that patients who perceive racial or ethnic discrimination are at greater risk for poor health and risky health behaviors (e.g., smoking, substance abuse). To support the development of targeted interventions to reduce instances of discrimination and minimize the negative consequences of perceived discrimination for those most at risk, it is necessary to identify vulnerable patient populations and/or healthcare settings in which patients are more likely to perceive discrimination. This study examined rates of perceived discrimination in healthcare settings for Veterans and non-Veterans, as well as for Veterans who used the VA healthcare system and those who did not. Investigators used data from the Behavioral Risk Factor Surveillance System (BRFSS) – a national telephone survey conducted annually. Investigators focused on BRFSS data for 35,902 survey respondents from 2004 who resided in seven states and the District of Columbia.


  • Although the study sample is representative of the states from which it was drawn, it is not representative of the Veterans within those states.
  • The BRFSS survey only assessed racial discrimination in health care and it is possible that evaluations of other types of potential discrimination (e.g. by gender) would have demonstrated different results.

Drs. Hausmann, Kressin, and Ibrahim were supported by HSR&D Career Development Awards. Drs. Hausmann and Ibrahim are part of HSR&D’s Center for Health Equity Research and Promotion in Pittsburgh; Dr. Kressin is part of HSR&D’s Center for Health Quality, Outcomes and Economic Research in Bedford, MA.

PubMed Logo Hausmann L, Jeong K, Bost J, Kressin N, and Ibrahim S. Perceived Racial Discrimination in Health Care: A Comparison of Veterans Affairs and Other Patients. American Journal of Public Health July 2009;99(7): E-pub, May 14, 2009.

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What are HSR Publication Briefs?

HSR requires notification by HSR-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR published articles. Visit the HSR citations database for a complete listing of HSR articles and presentations.

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