Association between prior experiences of discrimination and patients' attitudes towards health care providers collecting information about race and ethnicity

BACKGROUND: Previously, we reported a high level of comfort among Californians for collecting race/ethnicity information by health care providers (HCPs). However, minorities were less comfortable providing race/ethnicity information and were more worried than non-Hispanic whites about the potential misuse of this information. OBJECTIVE: To determine if perceived experiences of discrimination (both in general and in medical care) were associated with comfort providing race/ethnicity information, and conversely, to worry about providing the information. DESIGN AND PARTICIPANTS: Telephone survey of 480 Californians, including 101 whites, 98 Asians, 173 Hispanics, 82 blacks, and 26 multiracial individuals. MEASUREMENTS: Comfort level giving HCPs information about race/ethnicity (measured on a 1-10 scale, with text anchors of "very uncomfortable" at 1 and "very comfortable" at 10), worry that the information could be used to discriminate against patients, and worry that the information could be used to find undocumented immigrants. Worry was measured using a four-point Likert scale- not worried at all, a little worried, somewhat worried, and very worried. Respondents were also asked about perceived discrimination in general and perceived discrimination in medical care. RESULTS: Compared to whites, Hispanics (Beta-coefficient (BC) = -1.16, SE∈=∈0.51) and Mandarin/Cantonese-speaking Asians (BC∈=∈-1. 40, SE∈=∈0.65) reported significantly less comfort giving HCPs information about their race/ethnicity, while blacks (BC∈=∈0.70, SE∈=∈0.16), Hispanics (BC∈=∈0.91, SE∈=∈0.18), and multiracial individuals (BC∈=∈0.63, SE∈=∈0.24) were significantly more worried that race/ethnicity information could be used to discriminate against them. Adjusting for perceived experiences of discrimination in general and in medical care partially explained the higher discomfort and worry among minorities. CONCLUSIONS: Perceived experiences of discrimination are associated with greater discomfort and worry about providing race/ethnicity data. Health care institutions should consider how they can address the public's concerns about possible misuses of data.