Perceived discrimination among racial and ethnic minority drug users and the association with health care utilization

Courtney Mcknight, Martha Shumway, Carmen L. Masson, Enrique R. Pouget, Ashly E. Jordan, Don Des Jarlais, James L. Sorensen, David C. Perlman

Research output: Contribution to journalArticle

Abstract

People who use drugs (PWUDs) are at increased risk for several medical conditions, yet they delay seeking medical care and utilize emergency departments (EDs) as their primary source of care. Limited research regarding perceived discrimination and PWUDs’ use of health care services exists. This study explores the association between interpersonal and institutional racial/ethnic and drug use discrimination in health care settings and health care utilization among respondents (N = 192) recruited from methadone maintenance treatment programs (36%), HIV primary care clinics (35%), and syringe exchange programs (29%) in New York City (n = 88) and San Francisco (n = 104). The Kaiser Family Foundation Survey of Race, Ethnicity, and Medical Care questionnaire was utilized to assess perceived institutional racial/ethnic and drug use discrimination. Perceived institutional discrimination was examined across race/ethnicity and by regular use of ERs, having a regular doctor, and consistent health insurance. Perceived interpersonal discrimination was examined by race/ethnicity. Perceived interpersonal drug use discrimination was the most common type of discrimination experienced in health care settings. Perceptions of institutional discrimination related to race/ethnicity and drug use among non-Hispanic Whites did not significantly differ from those among non-Hispanic Blacks or Hispanics. A perception of less frequent institutional racial/ethnic and drug use discrimination in health care settings was associated with increased odds of having a regular doctor. Awareness of perceived interpersonal and institutional discrimination in certain populations and the effect on health care service utilization should inform future intervention development to help reduce discrimination and improve health care utilization among PWUDs.

Original languageEnglish (US)
Pages (from-to)404-419
Number of pages16
JournalJournal of Ethnicity in Substance Abuse
Volume16
Issue number4
DOIs
StatePublished - Oct 2 2017

Fingerprint

Patient Acceptance of Health Care
Racism
Drug Users
national minority
racism
discrimination
utilization
health care
drug
drug use
Pharmaceutical Preparations
ethnicity
Delivery of Health Care
health care services
medical care
Health Services
Primary Health Care
Discrimination (Psychology)
Needle-Exchange Programs
San Francisco

Keywords

  • Discrimination
  • drug use
  • health care access
  • persons who inject drugs
  • persons who use drugs
  • stigma

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health(social science)

Cite this

Perceived discrimination among racial and ethnic minority drug users and the association with health care utilization. / Mcknight, Courtney; Shumway, Martha; Masson, Carmen L.; Pouget, Enrique R.; Jordan, Ashly E.; Des Jarlais, Don; Sorensen, James L.; Perlman, David C.

In: Journal of Ethnicity in Substance Abuse, Vol. 16, No. 4, 02.10.2017, p. 404-419.

Research output: Contribution to journalArticle

Mcknight, Courtney ; Shumway, Martha ; Masson, Carmen L. ; Pouget, Enrique R. ; Jordan, Ashly E. ; Des Jarlais, Don ; Sorensen, James L. ; Perlman, David C. / Perceived discrimination among racial and ethnic minority drug users and the association with health care utilization. In: Journal of Ethnicity in Substance Abuse. 2017 ; Vol. 16, No. 4. pp. 404-419.
@article{520eed3ad7894ce09b9f78f90c519947,
title = "Perceived discrimination among racial and ethnic minority drug users and the association with health care utilization",
abstract = "People who use drugs (PWUDs) are at increased risk for several medical conditions, yet they delay seeking medical care and utilize emergency departments (EDs) as their primary source of care. Limited research regarding perceived discrimination and PWUDs’ use of health care services exists. This study explores the association between interpersonal and institutional racial/ethnic and drug use discrimination in health care settings and health care utilization among respondents (N = 192) recruited from methadone maintenance treatment programs (36{\%}), HIV primary care clinics (35{\%}), and syringe exchange programs (29{\%}) in New York City (n = 88) and San Francisco (n = 104). The Kaiser Family Foundation Survey of Race, Ethnicity, and Medical Care questionnaire was utilized to assess perceived institutional racial/ethnic and drug use discrimination. Perceived institutional discrimination was examined across race/ethnicity and by regular use of ERs, having a regular doctor, and consistent health insurance. Perceived interpersonal discrimination was examined by race/ethnicity. Perceived interpersonal drug use discrimination was the most common type of discrimination experienced in health care settings. Perceptions of institutional discrimination related to race/ethnicity and drug use among non-Hispanic Whites did not significantly differ from those among non-Hispanic Blacks or Hispanics. A perception of less frequent institutional racial/ethnic and drug use discrimination in health care settings was associated with increased odds of having a regular doctor. Awareness of perceived interpersonal and institutional discrimination in certain populations and the effect on health care service utilization should inform future intervention development to help reduce discrimination and improve health care utilization among PWUDs.",
keywords = "Discrimination, drug use, health care access, persons who inject drugs, persons who use drugs, stigma",
author = "Courtney Mcknight and Martha Shumway and Masson, {Carmen L.} and Pouget, {Enrique R.} and Jordan, {Ashly E.} and {Des Jarlais}, Don and Sorensen, {James L.} and Perlman, {David C.}",
year = "2017",
month = "10",
day = "2",
doi = "10.1080/15332640.2017.1292418",
language = "English (US)",
volume = "16",
pages = "404--419",
journal = "Journal of Ethnicity in Substance Abuse",
issn = "1533-2640",
publisher = "Routledge",
number = "4",

}

TY - JOUR

T1 - Perceived discrimination among racial and ethnic minority drug users and the association with health care utilization

AU - Mcknight, Courtney

AU - Shumway, Martha

AU - Masson, Carmen L.

AU - Pouget, Enrique R.

AU - Jordan, Ashly E.

AU - Des Jarlais, Don

AU - Sorensen, James L.

AU - Perlman, David C.

PY - 2017/10/2

Y1 - 2017/10/2

N2 - People who use drugs (PWUDs) are at increased risk for several medical conditions, yet they delay seeking medical care and utilize emergency departments (EDs) as their primary source of care. Limited research regarding perceived discrimination and PWUDs’ use of health care services exists. This study explores the association between interpersonal and institutional racial/ethnic and drug use discrimination in health care settings and health care utilization among respondents (N = 192) recruited from methadone maintenance treatment programs (36%), HIV primary care clinics (35%), and syringe exchange programs (29%) in New York City (n = 88) and San Francisco (n = 104). The Kaiser Family Foundation Survey of Race, Ethnicity, and Medical Care questionnaire was utilized to assess perceived institutional racial/ethnic and drug use discrimination. Perceived institutional discrimination was examined across race/ethnicity and by regular use of ERs, having a regular doctor, and consistent health insurance. Perceived interpersonal discrimination was examined by race/ethnicity. Perceived interpersonal drug use discrimination was the most common type of discrimination experienced in health care settings. Perceptions of institutional discrimination related to race/ethnicity and drug use among non-Hispanic Whites did not significantly differ from those among non-Hispanic Blacks or Hispanics. A perception of less frequent institutional racial/ethnic and drug use discrimination in health care settings was associated with increased odds of having a regular doctor. Awareness of perceived interpersonal and institutional discrimination in certain populations and the effect on health care service utilization should inform future intervention development to help reduce discrimination and improve health care utilization among PWUDs.

AB - People who use drugs (PWUDs) are at increased risk for several medical conditions, yet they delay seeking medical care and utilize emergency departments (EDs) as their primary source of care. Limited research regarding perceived discrimination and PWUDs’ use of health care services exists. This study explores the association between interpersonal and institutional racial/ethnic and drug use discrimination in health care settings and health care utilization among respondents (N = 192) recruited from methadone maintenance treatment programs (36%), HIV primary care clinics (35%), and syringe exchange programs (29%) in New York City (n = 88) and San Francisco (n = 104). The Kaiser Family Foundation Survey of Race, Ethnicity, and Medical Care questionnaire was utilized to assess perceived institutional racial/ethnic and drug use discrimination. Perceived institutional discrimination was examined across race/ethnicity and by regular use of ERs, having a regular doctor, and consistent health insurance. Perceived interpersonal discrimination was examined by race/ethnicity. Perceived interpersonal drug use discrimination was the most common type of discrimination experienced in health care settings. Perceptions of institutional discrimination related to race/ethnicity and drug use among non-Hispanic Whites did not significantly differ from those among non-Hispanic Blacks or Hispanics. A perception of less frequent institutional racial/ethnic and drug use discrimination in health care settings was associated with increased odds of having a regular doctor. Awareness of perceived interpersonal and institutional discrimination in certain populations and the effect on health care service utilization should inform future intervention development to help reduce discrimination and improve health care utilization among PWUDs.

KW - Discrimination

KW - drug use

KW - health care access

KW - persons who inject drugs

KW - persons who use drugs

KW - stigma

UR - http://www.scopus.com/inward/record.url?scp=85015644904&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85015644904&partnerID=8YFLogxK

U2 - 10.1080/15332640.2017.1292418

DO - 10.1080/15332640.2017.1292418

M3 - Article

C2 - 28306386

AN - SCOPUS:85015644904

VL - 16

SP - 404

EP - 419

JO - Journal of Ethnicity in Substance Abuse

JF - Journal of Ethnicity in Substance Abuse

SN - 1533-2640

IS - 4

ER -