Perceived disrespectful treatment in low-income healthcare settings through the lens of intersectionality

Abstract

Race and gender differences in the quality of one’s health care encounters are widely documented, but few studies explore the multiplicative impacts of race and gender. Drawing on intersectionality frameworks, we contrast white, Black, Hispanic, Asian, and Native American men’s and women’s perceptions of disrespectful treatment from health care providers and staff (e.g., receptionists, clerks) in low-income health settings. Data are from the 2014 Health Center Patient Survey (N = 5385), a nationally representative survey of community-dwelling patients receiving care at health centers funded through Section 330 of the Public Health Service Act. Our results show race and sex differences in the study outcomes, yet weak support for intersectional effects. Asian and Native American patients report more disrespectful treatment from providers, relative to other ethnic groups. Women are more likely than men to report disrespectful treatment from staff. Asians also report disrespectful treatment from staff. Health care providers and staff may require training focused on the distinctive needs of Asian patients, for whom “saving face” may be a salient goal. Structural changes to reduce wait times and employ medical interpreters to ensure clear communication, and staff training focused on verbal and nonverbal communication may mitigate against actions perceived as disrespectful in low-income health settings.