Black Adults Less Likely to Be the Same Race as Their Provider

The report states that “Historical medical mistreatment of Black people in America, and other people of color, has contributed to a mistrust of healthcare providers within these groups. Perceptions of a shared identity between patients and providers could be one way to improve the patient-provider relationship and foster trust and better communication.”

Further, “This brief draws on data from the April 2021 round of the Urban Institute’s Health Reform Monitoring Survey, a nationally representative, internet-based survey of adults ages 18 to 64. Launched in 2013, the HRMS was originally designed to provide timely information on the Affordable Care Act before federal survey data became available. In 2020, the Urban Institute updated the design and content of the HRMS to focus on the impact of the COVID-19 pandemic and support analyses of vulnerable populations so that the survey continues to provide timely data on critical policy issues. A total of 9,067 adults participated in the most recent round of the HRMS between April 2 and 20, 2021, and 82 percent of respondents completed the survey by April 8.”

Key findings from the report include:

• Black adult respondents were less likely to be the same race as their healthcare providers (22.2 percent) than white adults (73.8 percent), or adults of other races (34.4 percent)
• Less than one in four Hispanic/Latinx adult respondents (23.1 percent) said they shared a racial, ethnic, or language background with their provider
• Hispanic/Latinx adult respondents (55.8 percent) and non-Hispanic/Latinx Black adult respondents (65.6 percent) were less likely to have a usual healthcare provider than non-Hispanic/Latinx white adults (70.4 percent)
• Uninsured adult respondents were less likely to have a usual healthcare provider (28.5 percent) than adults with public or private health insurance (68.3 percent and 72.8 percent)

The authors of the report add that “We find that among non-Hispanic/Latinx adults, Black adults were less likely than other adults to report racial concordance with their usual health care providers. Additionally, only about one in four Hispanic/Latinx adults reported that their provider is their same race and ethnicity and speaks to them in their preferred language. Our analysis focuses on concordance between patients and their usual healthcare providers, meaning we do not know if respondents without a usual provider see providers of their same racial, ethnic, and linguistic background when they seek healthcare.”

Moreover, the report addresses the limited access to medical education for providers of color and how it has led to an underrepresentation of Black individuals in the physician workforce. Barriers to medical education include costs like tuition, application fees, exam fees, and travel costs for interviews. The authors say that tuition-free programs and scholarships are key steps to solving the disparity seen in the healthcare workforce.

The authors also touch on access to medical interpretation services. Despite federal regulations regarding access to language services, not all providers meet these regulations. If cost is an issue for providers, the report says that most Medicare programs reimburse for language services but sometimes it is not enough. Hiring multilingual staff can help, according to the authors, and another strategy that could be used is admitting more individuals to medical schools who speak another language.