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Member Research & Reports

Member Research & Reports

UNC Finds That Age-Related Discrimination Can Add to Health-Care Woes

Experiencing discrimination in the health-care system is not just distressing for older Americans. It literally can be bad for their health.

A national survey shows that one in every three older Americans who are on the receiving end of age-related discrimination in the health-care setting likely will develop new or worsened functional ailments in due course. This follows a study co-authored by Dr. Angela Thrasher, assistant professor of health behavior at The University of North Carolina at Chapel Hill’s Gillings School of Global Public Health.

thrasher_angela collage_thrasher by allison mathews_others by healthcliff o'malley
[Photo: Dr. Angela Thrasher (left, photographed by Allison Mathews) with images of elderly patients, all photographed by Heathcliff O’Malley. “Health-care discrimination and other negative aspects of the patient experience are impediments to quality care in ways that may hasten functional decline for older adults,” Dr. Thrasher says]

The study, published online March 13 in the Journal of General Internal Medicine, is the first to investigate specifically the health effects that discrimination experienced in health-care settings has on older adults. Dr. Thrasher and her colleagues analyzed data from 6,017 Americans ages 50 years and older who took part in the 2008, 2010 and 2012 iterations of the nationally representative “Health and Retirement Study.” The survey assessed important aspects of the aging process, and included questions about health-care discrimination.

One in every five respondents experienced health care-related discrimination. Age was the most common reason cited for being on the receiving end of such behavior. This was true for respondents of all sexes and age groups, as well as those who have difficulty completing daily tasks. It was also the number one reason given by members of most racial or ethnic groups, except among African-Americans.

Follow-up analyses showed that almost a third of older adults (28.5 percent) who frequently experienced such discrimination subsequently developed new or worsened disabilities over the course of the four-year study period. In contrast, participants who never or seldom experienced such treatment were more likely to maintain their health status.

These results suggest that health-care discrimination differs from discrimination outside of the medical setting. It may be more strongly linked to the development of disability among older patients and their increased inability to care for themselves.

“America is in the midst of a dramatic shift to an aging population, and providing high-quality medical care is fundamental to ensuring that these longer lives are as healthy and productive as possible,” said Dr. Thrasher, who is a member of the Global Aging and Technology Collaborative at the Gillings School. “Health-care discrimination and other negative aspects of the patient experience are impediments to quality care in ways that may hasten functional decline for older adults.”

The research team ended the paper with a call for further investigation into the reasons, sources and precise nature of the relationship between health-care discrimination and the development of disability.

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