Discrimination in health care settings is an understudied factor in health care access and health outcomes, particularly for mental health. Direct measures of unfair treatment from health care providers are relatively rare, and even fewer studies have looked specifically at the intersections of multiple forms of unfair treatment in relation to provider discrimination, health care access, and mental health.
Our recently published manuscript, titled “The Effects of Three Forms of Provider Discrimination on Access to Health Care and Mental Health” and authored by Kathleen Thiede Call, SHADAC Senior Research Associate Natalie Schwehr Mac Arthur, Cynthia Pando, Jinhee Cha, and Rhonda Jones-Webb examines these topics in depth.
Examining Provider Discrimination in Health Care Using Minnesota Health Access Survey (MNHA) Data
The Minnesota Health Access Survey (MNHA) is a representative data source that measures people’s experiences accessing and using health care in Minnesota, including unfair treatment from health care providers. This biennial survey describes health care access and utilization, health outcomes, and demographic characteristics for the Minnesota population.
In this study, we looked at the separate and combined effects of reports of three forms of provider discrimination. This included discrimination based on:
- Race, ethnicity, or nationality
- Gender or sexual orientation
- Insurance type or lack of insurance
Outcomes examined in this study included:
- Forgone mental health or behavioral health care due to cost
- Confidence in getting needed care
- Mentally unhealthy days in the past month (14 or more).
We found that about one in five adults in Minnesota reported at least one form of provider discrimination (19.6%), with many populations reporting higher rates. Experiencing provider discrimination based on either insurance status or based on gender or sexual orientation alone, together, or in combination with race-based discrimination was associated with forgone care – specifically forgone mental or behavioral health care, low confidence in getting needed care, and worse mental health. In the full publication, we recommend and describe several structural solutions.
Learn more about these proposed solutions along with additional data and analysis of provider discrimination in Minnesota in the published manuscript.