Prevalence and Patterns of Discrimination among U.S. Health Care Consumers

2003 ◽  
Vol 33 (2) ◽  
pp. 331-344 ◽  
Author(s):  
Thomas A. LaVeist ◽  
Nicole C. Rolley ◽  
Chamberlain Diala
Keyword(s):  
Health Care ◽  
Social Status ◽  
Low Income ◽  
Minority Health ◽  
Sex Discrimination ◽  
Age Discrimination ◽  
Class Discrimination ◽  
Disability Status ◽  
Race Ethnicity ◽  
Using Data

The authors examine the prevalence and patterns of perceived discrimination in the U.S. health care system and examine social status variables as determinants, using data from the Commonwealth Fund's Minority Health Survey. The primary social status groups of interest are age, race, ethnicity, social class, sex, and health status. Each social status category placed respondents at greater risk of perceiving discrimination based on the corresponding source of discrimination. That is, younger respondents were more likely to perceive age discrimination than were older respondents. African Americans and Hispanics perceived more race discrimination than whites. Low-income individuals experienced class discrimination, women experienced sex discrimination, and individuals who reported being in poor health were more likely to perceive discrimination based on health or disability status.

Low-Income Multigenerational Households

2008 ◽  
Vol 29 (7) ◽  
pp. 851-881 ◽  
Author(s):  
Laura D. Pittman ◽  
Michelle K. Boswell
Keyword(s):  
Problem Behaviors ◽  
Low Income ◽  
Culturally Diverse ◽  
Children And Families ◽  
Effective Parenting ◽  
Multigenerational Households ◽  
Positive Behaviors ◽  
Culturally Diverse Families ◽  
Race Ethnicity ◽  
Using Data

This article compares characteristics of families, mothers, and children on the basis of whether their household is multigenerational, using data from Welfare, Children, and Families: A Three-City Study, which samples low-income culturally diverse families. Few differences were found between multigenerational and nonmultigenerational households, although mothers in multigenerational households reported more internalizing behaviors and fewer positive behaviors in their children. However, interactions between household type, mothers' age, and race/ethnicity reveal that all multigenerational households are not alike. Multigenerational households with younger mothers tend to use less effective parenting and have children who are experiencing more problem behaviors. Race/ethnicity further moderates these associations in models predicting mothers' mental health and children's academic achievement. Possible reasons for these differences by mothers' age and race/ethnicity are discussed.

The Compounding Effect of Race/Ethnicity and Disability Status on Children’s Health and Health Care by Geography in the United States

Medical Care ◽  
2020 ◽  
Vol 58 (12) ◽  
pp. 1059-1068
Author(s):  
Ilhom Akobirshoev ◽  
Monika Mitra ◽  
Frank S. Li ◽  
Robert Dembo ◽  
Dan Dooley ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
The United States ◽  
Children's Health ◽  
Children’S Health ◽  
Disability Status ◽  
Race Ethnicity

Influence of age on receipt of chemotherapy for adult Medicaid beneficiaries with metastatic colorectal cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9548-9548
Author(s):  
H. D. Klepin ◽  
E. Y. Song ◽  
A. M. Geiger ◽  
J. A. Tooze ◽  
K. L. Foley
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Metastatic Colorectal Cancer ◽  
Low Income ◽  
Care Setting ◽  
Academic Medical Center ◽  
Local Treatment ◽  
Local Therapy ◽  
Health Care Setting ◽  
Race Ethnicity

9548 Background: Although advances in systemic treatment for metastatic colorectal cancer (CRC) have improved survival, it is unclear if this treatment is administered routinely among vulnerable individuals. Our objective was to describe treatment patterns for low income individuals with metastatic CRC and evaluate the influence of age on delivery of treatment in the context of patient, community, and health care setting characteristics. Methods: Matched North Carolina Cancer Registry and Medicaid claims data were used to identify a cohort of 390 patients with metastatic CRC diagnosed between 1999 and 2002. We assessed the relationship between treatment delivered within one year of diagnosis and characteristics of the patient (age, gender, race/ethnicity, comorbidity), community (percent poverty, percent rural), and health care setting (academic medical center, surgery volume). Treatment delivery was categorized into: 1) receipt of any chemotherapy, 2) local therapy only, and 3) no treatment. We fit a logistic regression model comparing receipt of any chemotherapy to local treatment only and another comparing receipt of any chemotherapy to no treatment. Results: Patients' mean age was 65.1±14.6 years; 56.0% were female and 45.5% were non-white. Only 27.7% received chemotherapy, while 50.3% received local therapy only and 22.0% received no treatment. After adjusting for comorbidity and all other covariates, patients aged <75 years were more likely to receive chemotherapy than patients ≥75 (versus local treatment only, OR=3.2, 95% CI=1.7–6.1; versus no treatment, OR=3.9, 95% CI=1.9–8.3). Absence of significant comorbidity was associated with use of chemotherapy only when compared to those who received no treatment (OR=3.1, 95% CI=1.6–5.9). Race/ethnicity, community, and health care setting characteristics were not associated with treatment. Conclusions: Use of chemotherapy in this low income cohort was low compared to published reports in other populations. Younger age was the only characteristic in this analysis which was consistently associated with receipt of chemotherapy. These results suggest that older low income patients may represent a particularly vulnerable population with regard to treatment disparity. No significant financial relationships to disclose.

scholarly journals Is age discrimination a less serious form of discrimination?

Legal Studies ◽  
2019 ◽  
Vol 39 (3) ◽  
pp. 533-549
Author(s):  
Stuart Goosey
Keyword(s):  
Social Status ◽  
Sex Discrimination ◽  
Case Law ◽  
Prima Facie ◽  
Age Discrimination ◽  
Differential Treatment ◽  
Inequality Of Opportunity ◽  
Social Equality ◽  
Social Worth ◽  
The Uk

AbstractThe UK courts and the CJEU have often treated age discrimination as a less serious form of discrimination. This is reflected in the courts’ reluctance to offer rigorous scrutiny when evaluating whether age-differential treatment is objectively justified under anti-discrimination law. Further, a number of judges have asserted that age discrimination must be understood as different to other forms of discrimination, such as race or sex discrimination. This paper argues that age discrimination is not fundamentally different or prima facie less serious than other forms of discrimination. Age discrimination can undermine the same principles that paradigm forms of discrimination also undermine, including: creating inequality of opportunity by disadvantaging people because of a trait that is outside a person's control; undermining social equality by creating a hierarchy of social status between different groups; violating autonomy by diminishing people's capacity to have control over their lives; and communicating disrespect by conveying that particular groups have a diminished moral or social worth. It follows, contrary to the approach of much of the case law, that the courts should offer rigorous scrutiny of age-differential treatment to identify these harms and only permit age distinctions that are strictly tailored to enhance equality or other important values.

scholarly journals Neighborhood Access to Transit by Race, Ethnicity, and Poverty in Portland, OR

2013 ◽  
Vol 12 (2) ◽  
pp. 134-155 ◽  
Author(s):  
Brian S. McKenzie
Keyword(s):  
Vulnerable Populations ◽  
Low Income ◽  
Spatial Mismatch ◽  
Low Income Population ◽  
The Poor ◽  
Race Ethnicity ◽  
High Concentrations ◽  
Using Data ◽  
In Transit ◽  
Housing Options

Scholarly discussions of accessibility and spatial mismatch largely ignore transit's role in linking vulnerable populations to opportunity. Yet as the nation's low–income population has become more suburban in recent decades, transit access may become an increasingly valuable, yet scarcer link to opportunity for those with the fewest resources and housing options. This study explores differences in transit access for neighborhoods with high concentrations of heavy transit users. Using data from the 2000 Census and the 5–year 2005–2009 ACS, it compares changes in transit access levels across neighborhoods with high concentrations of blacks, Latinos, and the poor in Portland, OR. Results show that Portland's neighborhoods of Latino concentration had the poorest relative access to transit. Further, levels of transit access declined for neighborhoods of black and Latino concentration during the study period.

scholarly journals EXPLORING THE MULTIDIMENSIONAL BIOPSYCHOSOCIAL PATHWAYS LINKING SOCIAL STATUS AND HEALTH AMONG OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S818-S818
Author(s):  
Heather R Farmer ◽  
Amy Thierry ◽  
Linda A Wray
Keyword(s):  
Older Adults ◽  
Social Status ◽  
Well Being ◽  
The United States ◽  
Physical And Mental Health ◽  
Race And Gender ◽  
Reactive Protein ◽  
Race Ethnicity ◽  
And Gender ◽  
Using Data

Abstract An abundant literature has documented the social patterning of health, where those with lower social status experience poorer outcomes relative to those with higher status. This symposium examines how social status (e.g., age, race/ethnicity, gender, and SES) impacts various aspects of midlife and older adults’ lives and their psychological and physical health. The research presented in this symposium lend support to utilizing a biopsychosocial framework for understanding mechanisms of health and aging. First, Heather Farmer et al. will explore race and gender differences in elevated C-reactive protein (CRP), a marker of inflammation linked to poor acute and chronic outcomes, using data from the Health and Retirement Study (HRS). Linda Wray and Amy Thierry will use HRS data to test whether race/ethnicity and sex interact to produce unequal outcomes in functional status. Jen Wong et al. will utilize data from the Midlife in the United States (MIDUS) survey to investigate the moderating influences of age, gender, marital status, and social support on caregiving and psychological well-being. Collin Mueller and Heather Farmer will use HRS data to examine how perceptions of unfair treatment are associated with healthcare satisfaction and self-rated health across Black, Latinx, and White subpopulations. Taken together, this work highlights the need for a comprehensive approach to better address physical and mental health disparities over the life course. After attending this session, participants will have a stronger understanding of how social status shapes important outcomes in older adults’ lives and some of the mechanisms responsible for these variations.

scholarly journals Redistributive effects of health care out-of-pocket payments in Cameroon

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Augustin Ntembe ◽  
Regina Tawah ◽  
Elkanah Faux
Keyword(s):  
Health Care ◽  
Low Income ◽  
Health Care Financing ◽  
Household Survey ◽  
Poverty Line ◽  
Goods And Services ◽  
Income Groups ◽  
Out Of Pocket Payments ◽  
Redistributive Effects ◽  
Using Data

Abstract Background The bulk of health care financing in Cameroon is derived from out-of-pocket payments. Given that poverty is pervasive, with a third of the population living below the poverty line, health care financing from out-of-pocket payments is likely to have redistributive and equity effects. In addition, out-of-pocket payments on health care can limit the ability of households to afford non-healthcare goods and services. Method The study estimates the Kakwani index for analyzing tax progressivity and applies the model developed by Aronson, Johnson, and Lambert (1994) to measure the redistributive effects of health care financing using data from the 2014 Cameroon Household Survey. The estimated indexes measure the extent of the progressivity of health care payments and the reranking that results from the payments. Results The results indicate that out-of-pocket payments for health care in Cameroon in 2014 represented a significant share of household prepayment income. The results also show some evidence of inequity as few people change ranks after payment despite the slight progressivity of health care out-of-pocket payments. Conclusion The existence of some disparities among income groups implies that the burdens of ill-health and out-of-pocket payments are unequal. The detected disparities within income groups can be reduced by targeting low-income groups through increases in government expenditures on health care and pro-poor prioritization of the expenditures.

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