Perceived discrimination in health care among american Indians/Alaska natives

Objectives: We compared the prevalence of, and reasons for, perceived discrimination in health care among American Indian/Alaska Natives (AI/ANs) and persons of AI/AN + White heritage to African Americans, Asian Americans, and Whites. Design: Data on perceived discrimination were collected by the 2001 California Health Interview Survey (CHIS). We used chi-square tests to evaluate the prevalence of perceived discrimination and the reasons for perceived discrimination across racial groups. Setting: The 2001 CHIS, a telephone survey, one of the largest cross-sectional surveys ever conducted in the United States. Participants: Participants in this analysis were adults ≥18 years of age, interviewed from 55,000 households that took part in the survey. Interventions: Participants in the 2001 CHIS were asked "Thinking of your experiences with receiving health care in the past 12 months, have you felt you were discriminated against for any reason?" Respondents who endorsed this item were asked about possible reasons for the discrimination. Main Outcome Measures: 1) Does the prevalence of perceived discrimination in health care differ between AI/ANs, AI/AN + Whites, African Americans, Asian Americans, and Whites? and 2) Do the reasons for perceived discrimination in health care vary by race or ethnicity? Results: Discrimination was perceived by 7.1% of the AI/AN alone group, 8.8% of AI/AN + White respondents, 5.6% of African Americans, 4.3% of Whites, and 2.6% of Asian Americans. After adjusting for covariates, the odds of perceived discrimination were different for AI/AN + White (odds ratio [OR] =2.0, 95% confidence interval [CI] 1.5-2.5) and Asian American (OR=.5, 95% CI .4-.7) when compared to Whites. Conclusions: AI/ANs, and especially those who identify as AI/AN + White, were the most likely among racial groups to report discrimination in health care.