• Héctor E Alcalá, Amanda E Ng, Sujoy Gayen, and Alexander N Ortega.
• From the Department of Family, Population and Preventive Medicine, Program in Public Health, Stony Brook University, Stony Brook, NY (HEA, SG); Department of Epidemiology and Biostatistics, UMD School of Public Health, University of Maryland, College Park, MD (AEN); Dana and David Dornsife School of Public Health, Drexel University Department of Health Management and Policy, Philadelphia, PA 19104 (ANO). hectorapm@ucla.edu.
• J Am Board Fam Med. 2020 Jul 1; 33 (4): 580-591.

IntroductionDiscrimination can compromise access to and utilization of health care and lead to poorer health. As such, it is important to understand the factors associated with experiences of discrimination in health care.MethodsUsing data from the 2015 to 2017 California Health Interview Survey (n = 63,100), this study examined whether insurance types and sites of usual sources of care were associated with reasons for perceived discrimination in health care and whether the reasons were associated with delaying health care. Odds of study outcomes were calculated among insured adults using logistic regressions. Insurance coverage types and sites of usual sources of care were the main independent variables. Six reasons for lifetime discrimination in health care were examined: 1) dissatisfaction with the health care system, 2) race or skin color, 3) age, 4) way the participant speaks English or other barrier to communication, 5) insurance status or type, and 6) income or education.ResultsAdults with Medicaid perceived more discrimination due to race or skin color relative to those with employer-sponsored coverage. This association does not vary by race/ethnicity. Perceived discrimination due to 1) dissatisfaction with the health care system, 2) insurance status or type, and 3) barriers to communication were each associated with increased delays in getting needed medical care.ConclusionsFindings highlight potential insurance types and sources of care that could contribute to perceptions of being discriminated.© Copyright 2020 by the American Board of Family Medicine.

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