Many people from racial and ethnic minority groups brace themselves for insults and judgments before medical appointments, according to a new survey of patients that reaffirms the prevalence of racial discrimination in the US health system.

A KFF survey of nearly 6,300 patients with care over the past three years found that about 55% of Black adults feel they need to be more careful about their appearance in order to be treated equally. treated by doctors and other health providers. About half of American Indian, Alaska Native, and Hispanic patients feel the same, as do about 4 in 10 Asian patients.

In comparison, 29% of white people surveyed said they were worried about their appearance before the appointment.

“In 2023, the idea that any person should be prepared for discrimination will be sad on one hand and angry on the other,” Burgess Harrison, executive director of the National Minority Health Association, wrote in an email. “The stress it causes, plus any health issues involved, is crazy.”

Discrimination has long been a concern for patients and health care providers in the US, where racial disparities in health outcomes are greater and more unfavorable to Blacks.

A 30-year-old Hispanic man in Illinois who responded to the KFF survey told researchers that he wears clothes to health care appointments with the logo of the university where he works. He noticed, he said, that when health care providers learned he was a professor, they listened to him more and included him more in care decisions.

A 44-year-old Asian woman in California told researchers that her white male doctors ignored her concerns about breathing issues, telling her that “she was probably just thinking too much about to breathe.” He was later diagnosed with asthma.

The two respondents were not identified in the study.

The survey offers “a way to actually quantify what those experiences of racism and discrimination are, and the many ways it affects people’s lives,” said Samantha Artiga, KFF’s director of racial equity and health. policy program.

“For people who have been following these issues for a long time, the findings are not unexpected,” he said.

Other findings:

• A third of adults reported at least one of several negative experiences with a health care provider in the past three years, such as a professional assuming something about them without asking, or suggests that they are to blame for a health problem.
• Nearly a quarter of Black adults, 19% of Alaska Native and Native American adults, 15% of Hispanic adults, and 11% of Asian adults said they believe they have suffered negative treatment because of their race. or ethnicity.
• Twenty-two percent of black adults who became pregnant or gave birth in the past 10 years said they were denied the medication they thought they needed. Only 10% of white adults in similar circumstances reported the same complaint.

If people don’t feel respected or welcomed by their health care providers, they may be discouraged from seeking medical help or may switch providers frequently, Artiga said. . Members of minority populations have been found to “experience worse health because of experiencing unequal treatment in the health care system,” he said.

The survey also found that discrimination outside the health care system has health consequences. People who say they experience discrimination in their daily lives are more than twice as likely to report being often anxious, lonely, or sad compared to those who rarely or never face discrimination.

Black people who self-reported darker skin tones were more likely to experience discrimination than those with lighter skin, the survey found.

The survey revealed that “how persistent and widespread experiences of racism and discrimination remain today, in everyday life and also in health care, despite, in fact, the increasing number of calls and focus on solving of racism,” said Liz Hamel, KFF’s director of public opinion and surveys. research.

Diversity among health care providers is important, the survey found. Most people of color who participated in the survey said less than half of their medical visits in the past three years were with a provider of the same race or ethnicity. But black patients who had at least half of their visits with a provider of their race or ethnicity, for example, were more likely to report better experiences, such as their doctor explaining things ” in a way they can understand” or ask them about health factors such as their employment, housing, and access to food and transportation.

Nearly 40% of Black adults whose health providers are also Black said they discuss such economic and social topics, while only 24% of Black adults who see non-Black providers do so. as those issues are raised.

Harrison, of the National Minority Health Association, wrote that “a renewed emphasis on recruiting more people of color to health is important.”

The survey, he added, “painfully illustrates that racial bias in health care is as damaging as any disease.”

KFF’s “Survey on Racism, Discrimination and Health” was conducted from June 6 to August 14 online and by telephone among a nationally representative sample of US adults in English, Spanish, Chinese, Korean, and Vietnamese.