IMPACT OF RACISM ON MINORITY ELDERS NOT RECEIVING HEALTHCARE: MEDIATING ROLE OF POOR DOCTOR-PATIENT COMMUNICATION. (11th November 2018)

• Record Type: Journal Article
• Authors: Rhee, G; Marottoli, R; Van Ness, P; Levy, B
• Is Part Of: Innovation in aging. Volume 2(2018)Supplement 1
• Page Start: 229
• Page End: 229
• Publication Date: 2018-11-11
• Subjects: Aging -- Periodicals; Gerontology -- Periodicals; 612.67
• DOI: 10.1093/geroni/igy023.852
• Languages: English
• ISSNs: 2399-5300

Abstract

Abstract: Little is known about factors that contribute to delayed/forgone care in racial/ethnic minority older adults. We investigated if perceived racial/ethnic discrimination is associated with delayed/forgone care, and whether poor doctor-patient communication mediates this relationship in minority older adults. Data from the 2015 California Health Interview Survey were used. We limited our sample to adults ages 65 or older with complete covariates (n=6, 972 unweighted). Using a cross-sectional survey research design and a population-based sampling strategy, we conducted multivariable logistic regression analyses to estimate odds of having delayed or forgone care when adjusted for other covariates. Then, we performed mediation analyses to investigate whether poor doctor-patient communication mediates the relationship. We also performed stratified mediation analyses by race/ethnicity. In the full model, those who experienced racial/ethnic discrimination had 2.29 times higher odds of having delayed/forgone care (95% CI, 1.02–5.17) than did those who did not have such experiences. Having poor communication with a doctor had 3.07 times higher odds of having delayed/forgone care (95% CI, 1.98–4.75). In the adjusted mediation analysis, we confirmed that poor doctor-patient communication was a mediator. When stratified by race/ethnicity, neither perceived racial/ethnic discrimination nor doctor-patient communication was associated with delayed/forgone care among non-Hispanic whites. In contrast, among minority older adults, racial/ethnic discrimination was significantly associated with delayed/forgone care (odds ratio=3.60; 95% CI, 1.24–10.51), and the effect mediated by poor doctor communication was 9.9%. Findings suggest that improving doctor-patient interactions may reduce disparities in access to care in minority older adults.