African-American preference for same-race healthcare providers: The role of healthcare discrimination

Objective: To determine the extent to which African Americans prefer same-race clinicians and the extent to which: 1) knowledge of historical mistreatment; 2) perceptions of current racial inequities in medical treatment; and 3) personal experiences of discrimination are associated with preference for same-race healthcare providers among African Americans. Design: Statistical analysis of a nationally representative telephone survey designed by the Henry J. Kaiser Family Foundation and conducted by Princeton Survey Research Associates (PSRA). Bivariate significance is determined by using chi-square tests of association. Multinominal logistic regression models adjust for age, gender, income, education, and self-reported health status. Results: Approximately one in five African Americans states a preference for a same-race healthcare provider. Neither knowledge of historical mistreatment nor perceptions o current racial inequities in medical treatment are related to preferred race of healthcare providers. In contrast, personal experiences of discrimination in health care are associated with a preference for same-race healthcare providers. Conclusions: The results suggest that while knowledge of unfair treatment historically and perceptions of current racial inequity do not affect preferences, personal experiences of unfair treatment may have a significant effect on African-American patients' preferences regarding health care. Findings suggest that rather than focusing on how historical mistreatment and current inequities in medical treatment affect individual patients, research should focus on individual experiences.