Citation

Findling MG, Casey LS, Fryberg SA, Hafner S, Blendon RJ, Benson JM, Sayde JM, Miller C. Health Serv. Res. 2019; ePub(ePub): ePub.

Affiliation

Research, Evaluation, and Learning Unit, Robert Wood Johnson Foundation, Princeton, New Jersey.

Copyright

(Copyright © 2019, John Wiley and Sons)

DOI

10.1111/1475-6773.13224

PMID

31657013

Abstract

OBJECTIVE: To examine reported racial discrimination and harassment against Native Americans, which broadly contribute to poor health outcomes. DATA SOURCE AND STUDY DESIGN: Data come from a nationally representative, probability-based telephone survey including 342 Native American and 902 white US adults, conducted January-April 2017.

METHODS: We calculated the percent of Native Americans reporting discrimination in several domains, including health care. We used logistic regression to compare the Native American-white difference in odds of discrimination and conducted exploratory analyses among Native Americans only to examine variation by socioeconomic and geographic/neighborhood characteristics. PRINCIPAL FINDINGS: More than one in five Native Americans (23 percent) reported experiencing discrimination in clinical encounters, while 15 percent avoided seeking health care for themselves or family members due to anticipated discrimination. A notable share of Native Americans also reported they or family members have experienced violence (38 percent) or have been threatened or harassed (34 percent). In adjusted models, Native Americans had higher odds than whites of reporting discrimination across several domains, including health care and interactions with the police/courts. In exploratory analyses, the association between geographic/neighborhood characteristics and discrimination among Native Americans was mixed.

CONCLUSIONS: Discrimination and harassment are widely reported by Native Americans across multiple domains of their lives, regardless of geographic or neighborhood context. Native Americans report major disparities compared to whites in fair treatment by institutions, particularly with health care and police/courts.

RESULTS suggest modern forms of discrimination and harassment against Native Americans are systemic and untreated problems.

© 2019 The Authors. Health Services Research published by Wiley Periodicals, Inc. on behalf of Health Research and Educational Trust.

Language: en

Keywords

American Indian and Alaska Natives; Native Americans; discrimination; racial/ethnic disparities in health and health care; racism; social determinants of health; survey research