Everyday Discrimination and Health Care Utilization Among US Adults.
Everyday discrimination is associated with more cost-related barriers to medical care.
Everyday Discrimination and Health Care Utilization Among US Adults.
IMPORTANCE: Everyday discrimination, defined as repeated exposure to subtle slights and unfair treatment, has been reported to be associated with adverse health outcomes, but its association with health care use remains incompletely understood.
To examine the association between everyday discrimination and health care use among US adults.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study included 27 384 National Health Interview Survey respondents 18 years and older who completed the Everyday Discrimination Scale (Everyday Discrimination Scale) in 2023.
each point of reported discrimination raises the odds of skipping care over cost
The sample included 27 384 adults (mean [SD] age, 48.1 [18.5] years; 51.2% female [weighted percentage]).
The mean (SD) Everyday Discrimination Scale score was 2.48 (3.34).
Higher scores were also associated with greater use of emergency department visits (adjusted odds ratios, 1.05; 95% CI, 1.04-1.06), urgent care (adjusted odds ratios, 1.05; 95% CI, 1.04-1.06) but lower odds of physician visits (adjusted odds ratios, 0.97; 95% CI, 0.96-0.99) and dental visits (adjusted odds ratios, 0.98; 95% CI, 0.97-0.99).
In this cross-sectional study of 27 384 US adults, higher everyday discrimination scores were associated with higher reliance on emergency services and lower engagement with preventive care.
Interventions addressing interpersonal and structural forms of discrimination, including culturally responsive care, implicit bias training, patient navigation programs, and expanded primary care access, are essential to reduce discrimination's impact on health care use and outcomes.