Perceived discrimination in health care and use of preventive health services

OBJECTIVE: To examine the relationship between perceived discrimination and preventive health care utilization. DESIGN AND PARTICIPANTS: Cross-sectional analysis using the 2004 Behavioral Risk Factor Surveillance System Reactions to Race module (N = 28,839). MEASUREMENTS: Outcomes were self-reported utilization of seven preventive health services. Predictors included perceived negative and positive racial discrimination ( vs. none) while seeking health care in the past year. Multivariable models adjusted for additional patient characteristics. MAIN RESULTS: In unadjusted models, negative discrimination was significantly associated with less utilization of mammogram, pap test, PSA test, blood stool test, and sigmoidoscopy/colonoscopy (ORs = 0.53-0.73, p <.05), but not flu or pneumococcal vaccines (ORs = 0.76 and 0.84). Positive discrimination was significantly associated with more utilization of all services (ORs = 1.29-1.58, p <.05) except pap test (OR = 0.94). In adjusted models, neither negative nor positive discrimination was predictive of utilization, except for PSA test (positive discrimination OR = 1.33, p <.05). CONCLUSIONS: Perceived racial discrimination in health care does not independently predict preventive health care utilization.