Blacks' and Whites' Attitudes Toward Race and Nativity Concordance With Doctors

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Blacks’ and Whites’ Attitudes Toward Race
and Nativity Concordance With Doctors
Jennifer Malat, PhD; Michelle van Ryn, PhD, MPH; David Purcell, PhD



                                                                               affects patients’ perceptions of doctor-patient interac-
  Financial Support: Funding for this research was provided by
                                                                               tions, very little is known about patients’ general attitudes
  grants to Dr Malat from the Agency for Healthcare Research
                                                                               toward doctor race. Further, the national origin of medical
  and Quality (R03 HS 13280-01A1) and the Taft Research Cen-
                                                                               providers may influence the interpersonal dynamics of
  ter at the University of Cincinnati.
                                                                               medical encounters as well. However, although interna-
  Previous Presentation: An earlier version of this paper was                  tional medical graduates make up 25% of the US physi-
  presented at the 2005 annual meetings of the American                        cian workforce,1 there is very little empirical research on
  Sociological Association.                                                    patients’ attitudes toward doctors’ nativity.
                                                                                   This paper begins to fill the gaps in knowledge about
  While research shows that race is an important factor in
                                                                               patients’ thinking about doctors’ race and nativity by
  patient-doctor interaction, very little is known about patients’
                                                                               examining 2 specific components of patients’ attitudes
  attitudes toward doctors’ race or nativity. This paper exam-
                                                                               toward interactions with race-concordant vs discordant
  ines 2 specific components of these attitudes. We found
                                                                               providers, and foreign-born vs native-born providers: (1)
  that 16% of a Cincinnati, Ohio, sample believed that same-
                                                                               patients’ beliefs regarding doctors’ knowledge about
  race doctors better understand their health problems, and
                                                                               one’s health problems, and (2) patients’ expected ease
  22% expected to be more at ease with same-race doctors.
                                                                               with interpersonal interactions. Further, in order to
  Blacks were more likely than whites to hold this belief and
                                                                               expand understanding of these attitude dimensions, we
  expectation, with the largest racial difference among those
                                                                               examine whether these beliefs vary by patient race.
  with college degrees. Looking at nativity, nearly one-third
                                                                               Assessing the impact of race concordance and nativity on
  of the respondents believed that US-born doctors better
                                                                               attitudes toward providers will improve our understand-
  understand their health problems and expected to be more
                                                                               ing of the complex dynamics involved in doctor-patient
  at ease with US-born doctors. Again, blacks were more likely
                                                                               relationships for blacks and whites in the United States.
  than whites to report a more positive view of US-born doc-
  tors compared to foreign-born doctors, with the effect of
  race varying by education. Future research should further
                                                                               BACKGROUND
                                                                                   Black patients are much less likely than white patients
  explicate the nature of these attitudes and assess how these
                                                                               to see a race-concordant doctor. For example, one study
  attitudes affect health care interactions.
                                                                               found that black patients most often saw white doctors
  Keywords: patient-physician relationship n race/ethnicity                    (58.5%), followed by black doctors (21.7%) and Asian
  n education n knowledge, attitudes, and beliefs                              doctors (10.1%).2 This study found that whites most
                                                                               often saw white doctors (85.6%), with different-race
  J Natl Med Assoc. 2009;101:800-807                                           doctors most often being of Asian origin (7.5%).2
                                                                                   In addition to race concordance among patients and
Author Affiliations: Department of Sociology, University of
				
DOCUMENT INFO
Description: While research shows that race is an important factor in patient-doctor interaction, very little is known about patients' attitudes toward doctors' race or nativity. This paper examines 2 specific components of these attitudes. We found that 16% of a Cincinnati, Ohio, sample believed that same-race doctors better understand their health problems, and 22% expected to be more at ease with same-race doctors. Blacks were more likely than whites to hold this belief and expectation, with the largest racial difference among those with college degrees. Looking at nativity, nearly one-third of the respondents believed that US-born doctors better understand their health problems and expected to be more at ease with US-born doctors. Again, blacks were more likely than whites to report a more positive view of US-born doctors compared to foreign-born doctors, with the effect of race varying by education. Future research should further explicate the nature of these attitudes and assess how these attitudes affect health care interactions.
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