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Publication Briefs

Perceived Racial Discrimination in U.S Healthcare More Prevalent among African Americans and Associated with Worse Health Outcomes


  • The prevalence of perceived discrimination in U.S. healthcare is considerably higher for African Americans compared to Whites and Hispanics (10.9% vs. 2% and 5.2%, respectively). [These results were not based on VA data.]
  • Perceived discrimination was associated with worse health for both African Americans and Whites.
  • Discrimination was more often reported by males, the middle-aged (vs. 65 years and older), and people in the lowest two income brackets (vs. > $50,000 per year).
  • Health care coverage was not significantly related to perceived discrimination for any of the racial/ethnic groups. However, not obtaining medical care due to cost was associated with a greater likelihood of perceiving discrimination for all groups.

Strong evidence suggests that people who perceive more discrimination are at greater risk for reduced mental and physical health status, but relatively few studies have examined the health correlates of racial discrimination that occurs within a healthcare setting. This study used data from the 2004 Behavioral Risk Factor Surveillance System (BRFSS) survey to examine the prevalence of perceived racial discrimination in healthcare settings for the three largest racial/ethnic groups in the U.S.: Whites, African Americans, and Hispanics. Investigators also assessed the association between perceived racial discrimination and overall health status. The BRFSS is an annual telephone survey conducted by the CDC in individual states. As part of the 2004 BRFSS, seven states and the District of Columbia administered a “Reactions to Race” module that included a question regarding respondents’ perceived racial discrimination while seeking healthcare in the past 12 months. Analyses were based only on these states and Washington, DC.


  • This was a secondary analysis of existing, self-reported data.
  • The single-item measure of healthcare discrimination in the BRFSS data set was not ideal.
  • The “Reactions to Race” module was optional and was not administered to respondents in the majority of states.

Drs. Hausmann and Ibrahim were supported by HSR&D Career Development Awards and are both part of HSR&D’s Center for Health Equity Research and Promotion in Pittsburgh, PA.

PubMed Logo Hausmann L, Jeong K, Bost J, Ibrahim S. Perceived Discrimination in Health Care and Health Status in a Racially Diverse Sample Medical Care September 2008;46(9):905-914.

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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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