Getting to the Heart of Discrimination in Healthcare: Measures and Risks

Abstract

Discrimination in healthcare settings is a barrier to equitable healthcare delivery and may lead to poor health outcomes in patients. However, there is limited research on measures of discrimination in healthcare and its associated risks. In this dissertation, I conduct three studies to provide new evidence to help better understand the relevance and implications of discrimination in healthcare. First, I conduct a systematic review of measurement studies that assess the current tools available to capture discrimination in healthcare settings. Next, I use nationally-representative longitudinal data from the Health and Retirement Study to assess the association between discrimination in healthcare and long-term patterns of doctor visits. Third, I examine the association between discrimination in healthcare and non-fatal Atherosclerotic Cardiovascular Disease (ASCVD) in middle-aged and older adults. This work demonstrates that there are promising tools for measuring discrimination in healthcare, but further studies are warranted. Additionally, there are associations between reported discrimination in healthcare and numbers of doctor visits and risks for non-fatal ASCVD events.