How Discrimination in Health Care Affects Older Americans, and What Health Systems and Providers Can Do

Racial and ethnic discrimination has a significant impact on the health of people of color, affecting mental health and contributing to high blood pressure, negative health behaviors, and early aging, according to an issue brief released by the Commonwealth Fund. For Black older adults, the cumulative effects of race-related stress experienced over the course of a life can increase the risk for mental and physical health problems.

In health care settings, experiences of discrimination can include providers dismissing a patient’s symptoms or health concerns, offering different treatment based on a patient’s type of insurance, or not providing care in a patient’s preferred language.

The Commonwealth Fund’s issue brief highlights the following findings:

  • Older adults in the United States are more likely to report racial and ethnic discrimination in the health system exists, compared with their peers in 10 other high-income countries.
  • In the U.S., one in four Black and Latinx/Hispanic adults age 60 and older reported that they have been treated unfairly or have felt that their health concerns were not taken seriously by health professionals because of their racial or ethnic background.
  • More than a quarter of U.S. older adults said they did not get the care or treatment they felt they needed because of discrimination.
  • U.S. older adults who have experienced discrimination in a health care setting were more likely to have worse health status, face economic hardships, and be more dissatisfied with their care than those who did not experience discrimination.

Further on in the research report, the Commonwealth Fund offers a list of policy recommendations, including:

  • Promote transparency and accountability by identifying instances of discrimination and publicly reporting discrimination data.
  • Develop medical school curricula to educate students about how the U.S. health care system has harmed patients of color and other historically marginalized communities.
  • Examine how current policies enable discrimination and then remove or reform those policies.
  • Address the lack of diversity in the U.S. health care workforce.
  • Provide culturally and contextually appropriate care that addresses patients’ communication needs and preferences.