Survey Assesses Perceptions of Racial Disparities
By: Bill Bangert
African-American adults in Greater Cincinnati are more likely than white adults to report they believe their race and their ability to pay or their type of health insurance negatively impacted the treatment they received from medical professionals, according to a University of Cincinnati survey. Respondents also reported feeling they would have received better care if they belonged to a different race or ethnic group, or spoke English more fluently.
The survey found that 21 percent of African-American adults in the region think they would have received better medical care if they belonged to a different race or ethnic group, compared with only 5 percent of whites. Among African-American adults in the region, 14 percent felt they had been judged unfairly or treated disrespectfully by a doctor or medical staff member because of their race or ethnicity. This compares with about 1 percent of white adults.
"These results show the health disparities, specifically in our African-American community, continue to be a challenge for our region.” —Greer Glazer, PhD, Dean of UC College of Nursing
Ability to pay and type of health insurance also influenced perception of care. In the survey, 19 percent of African-Americans felt they had been judged unfairly or treated disrespectfully by medical staff because of their ability to pay for care or the type of health insurance they had, compared with 12 percent of whites. African-American adults were also slightly more likely to feel they had been discriminated against because of how they spoke English. Seven percent thought they would have received better medical care if they spoke English more fluently, compared with 2 percent of white adults.
"These results show the health disparities, specifically in our African-American community, continue to be a challenge for our region,” says Greer Glazer, PhD, associate vice president of health affairs and dean of UC College of Nursing. "Therefore we understand our responsibility to take the necessary steps to improve health care in this region.”
About the Survey
The findings come from the recent Greater Cincinnati Survey (GCS) Winter 2017, conducted by UC’s Institute for Policy Research. The GCS is a semiannual survey of adult residents of metropolitan Cincinnati based on telephone interviews with a randomly selected sample of approximately 1,000 Hamilton County residents and 1,500 residents of the eight-county region.
The questions were sponsored by the UC Transformation of Mission-Based Health Care Through Diversity Equity and Inclusion project with funding from Interact for Health. Directed by Glazer, Barbara Tobias, MD, professor of family and community medicine at the UC College of Medicine and medical director of The Health Collaborative, and Tammy Mentzel, MPH, research associate in the College of Nursing, the project aims to address the severe shortage of qualified health professionals in underserved areas by leveraging the power of urban universities to enhance and expand a culturally sensitive, diverse and prepared health workforce.
"As an Academic Health Center, UC recognizes that health disparities and discrimination in our community must be addressed together as we move toward greater health equity,” Tobias says.
Similar Results in Area Focus Groups
The Center for Closing the Health Gap in Greater Cincinnati reported similar findings in focus groups conducted with African-American males in 2017. In those focus groups, group participants reported that they felt that black men are impacted by the care they receive because of a lack of respect and unfair judgement from white doctors.
"Most black people have Medicaid, which tells the doctor right away that you are poor, and therefore, their stereotypes about African-Americans are compounded—black folks are poor, therefore no respect,” said one participant.
Participants also commented that race continues to be an underlying factor in the care received by African-American men when seeing health care providers. "Doctors believe African-Americans just don’t take care about themselves. They believe if we don’t care about ourselves, why should they?” said another respondent.
Participants also felt there were numerous instances where they would have received better medical care if they had a different type of insurance. "You will get adequate care with most insurances, but major procedures are not covered or are too costly with Medicaid. You get better treatment in an emergency room if you are homeless than if you have Medicaid,” said a participant.
Developing a Diverse Health Workforce
With the support of a $300,000 investment by former UC President Santa Ono, PhD, and continued by current President Neville Pinto, PhD, UC’s Mission-Based Health Care goals include:
- Working in collaboration with community stakeholders to develop a health workforce that increases access to health care and the opportunity for optimal health for all in the local urban community;
- Producing students who are culturally competent to ensure the local health care workforce has the background, qualities and skills to serve community needs and decrease health disparities; and
- Increasing education opportunity for talented and diverse students to be recruited in order to graduate a health care workforce that reflects the diversity of the population in the local urban community.
"It is our responsibility to teach our students about their responsibility in serving a diverse patient population,” says William Ball, MD, senior vice president for health affairs and dean of the UC College of Medicine. "We are committed to producing a diverse physician workforce and are well on the way with approximately 20 percent of our Class of 2021 being individuals from underrepresented minorities, the highest percentage ever in the College.”
In addition, UC’s Academic Health Center partnered with UC Health, the community’s only academic health system, in providing a $250,000 match from each of the four health colleges to create eight endowed diversity scholarships.
"At UC Health, we value inclusion and empathy and are committed to improving the health of all people by fostering groundbreaking medical research and education, delivering outstanding primary and specialty care services and building a diverse workforce,” says Richard Lofgren, MD, president and CEO of UC Health.