Health care workers see widespread racial, ethnic bias directed at patients and themselves

©wladimir1804-stock.adobe.com

Nearly half of U.S. health care workers have witnessed discrimination against patients or experienced it themselves, a new report finds, with younger employees and those of color especially likely to say they have seen it.

The report, Revealing Disparities: Health Care Workers’ Observations of Discrimination Against Patients, is based on a survey of more than 3,000 health care workers undertaken by the Commonwealth Fund and the African American Research Collaborative (AARC). The survey’s purpose was to understand the impact of racism and discrimination on health care workers and patients.

“The study shines a light on the discrimination and racism health care workers observe and the implications for negative health outcomes of patients in many communities,” Henry Fernandez, AARC’s CEO and the report’s lead author said in an accompanying news release.

“Understanding this connection at a national level is critical to measuring and addressing discrimination in the health care system to mitigate harm to patients and produce better health outcomes overall,” he added.

Among the report’s findings:

• More than half of health care workers (57%) witnessed discrimination against patients who predominantly speak a language other than English.
• About half (48%) said that medical providers are more accepting when white patients self-advocate than when Black patients do so.
• 70% of workers at facilities with predominantly Black patients and 61% of those working in facilities with mostly Latino patients witnessed discrimination compared with only 43% at facilities with mostly white patients.
• Nearly two-thirds (64%) of workers ages 18-29 say they have witnessed discrimination based on a patient’s race or ethnicity, compared to just 25% of workers age 60 and older.

Although the report focuses on the impact of discrimination on patients, the full survey examined racism and discrimination in health care settings generally, including discrimination toward health care professionals, as well as employers’ role in addressing these issues.

Notable findings from the larger survey include:

• 44% percent of all health care workers have observed coworkers subjected to racism in the workplace. When provided with examples of potential workplace discrimination, two-thirds indicate they have seen at least one of the examples.
• A majority (58%) of Black health care workers, 49% of Latino workers, and 44% of Asian American and Pacific Islander workers say they have experienced workplace discrimination due to their race or ethnicity.
• Slightly less than half (47%) of health care workers said that dealing with discrimination on the job is a source of stress.
• While majorities of health care workers think their employers are making efforts to address discrimination, majorities of Black, Latino and AAPI employees fear retaliation if they raise concerns around discrimination.

Asked about potential solutions, more than two-thirds of respondents thought the following steps could help:

• Providing an easy way to anonymously report situations involving racism or discrimination.

• Creating opportunities to listen to patients of color and health care professionals of color.

• Examining treatment of non-English-speaking patients.

•Providing training at professional schools or health care staff on how to identify discrimination.

“If we are going to build truly equitable health care systems, we have to start by listening to voices of those on the front lines,” said Laurie C. Zephyrin, M.D., senior vice president for advancing health equity at the Commonwealth Fund and report coauthor. “Understanding what health care workers are experiencing, and what they want and need from their employers and colleagues to address discrimination, is critical to successful and sustainable change.”