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Why Were African Americans Discriminated Agains

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. 2019 Dec;54 Suppl 2(Suppl 2):1399-1408.

doi: 10.1111/1475-6773.13220. Epub 2019 Oct 29.

Discrimination in the United States: Experiences of black Americans

Affiliations

  • PMID: 31663124
  • PMCID: PMC6864380
  • DOI: 10.1111/1475-6773.13220

Free PMC article

Discrimination in the United States: Experiences of black Americans

Sara N Bleich  et al. Health Serv Res. 2019 Dec .

Free PMC article

Abstract

Objective: To examine experiences of racial discrimination among black adults in the United States, which broadly contribute to their poor health outcomes.

Data source and study design: Data come from a nationally representative, probability-based telephone survey including 802 non-Hispanic black and a comparison group of 902 non-Hispanic white US adults, conducted January-April 2017.

Methods: We calculated the percent of blacks reporting discrimination in several domains, including health care. We used logistic regression to compare the black-white difference in odds of discrimination, and among blacks only to examine variation by socioeconomic status, gender, and neighborhood racial composition.

Principal findings: About one-third of blacks (32 percent) reported experiencing discrimination in clinical encounters, while 22 percent avoided seeking health care for themselves or family members due to anticipated discrimination. A majority of black adults reported experiencing discrimination in employment (57 percent in obtaining equal pay/promotions; 56 percent in applying for jobs), police interactions (60 percent reported being stopped/unfairly treated by police), and hearing microaggressions (52 percent) and racial slurs (51 percent). In adjusted models, blacks had significantly higher odds than whites of reporting discrimination in every domain. Among blacks, having a college degree was associated with higher odds of experiencing overall institutional discrimination.

Conclusions: The extent of reported discrimination across several areas of life suggests a broad pattern of discrimination against blacks in America, beyond isolated experiences. Black-white disparities exist on nearly all dimensions of experiences with public and private institutions, including health care and the police. Evidence of systemic discrimination suggests a need for more active institutional interventions to address racism in policy and practice.

Keywords: African Americans; black Americans; discrimination; racial disparities in health and health care; racism; social determinants of health; survey research.

Figures

Figure 1
Figure 1

Adjusted odds of experiencing discrimination among blacks compared to whites (reference group). OR, odds ratio, with 95% confidence interval bars. Nationally representative sample of black and white adults ages 18+. * Indicates statistical significance at P < .05. Don't know/refused responses coded as missing. Odds ratios report the odds that blacks reported experiencing discrimination for each outcomes (whites were the reference group). These estimates control for gender, age (18‐29, 30‐49, 50‐64, 65+), education (<college vs college graduate or more), household income (<25k, 25k‐<50k, 50k‐<75k, 75k+), living in a neighborhood that is predominantly one's own race, household location (urban, suburban, rural), region (Northeast, Midwest, South, West), and for health care outcomes only, health insurance status (uninsured, Medicaid insured, non‐Medicaid insured).a Equal pay question only asked among respondents who have ever been employed for pay. b Jobs question only asked among respondents who have ever applied for a job. c College application/attendance was only asked among respondents who have ever applied for college or attended college for any amount of time. d Includes discrimination against you or a family member because you are black/white. e Housing question only asked among respondents who have ever tried to rent a room or apartment, or to apply for a mortgage or buy a home. f Microaggressions indicate that someone made negative assumptions or insensitive or offensive comments about you because you are black/white. g Racial/ethnic slurs indicate that someone referred to you or your racial group using a slur or other negative word because you are black/white. h Racial/ethnic fear indicates that people acted as if they were afraid of you because you are black/white

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