Eliciting Patient Past Experiences of Healthcare Discrimination as a Potential Pathway to Reduce Health Disparities: A Qualitative Study of Primary Care Staff

Authors

• Dharma E. Cortés, Harvard Medical School
• Ana M. Progovac, Harvard Medical School
• Frederick Lu, Brown University
• Esther Lee, University of Michigan - Ann Arbor
• Nathaniel M. Tran, University of Illinois at Chicago
• Margo A. Moyer, John Snow Institute
• Varshini Odayar, Cambridge Health Alliance
• Caryn R.R. Rodgers, Albert Einstein College of Medicine
• Leslie Adams, Johns Hopkins Bloomberg School of Public Health
• Valeria Chambers, Cambridge Health Alliance
• Jonathan Delman, UMass Chan Medical School
• Deborah Delman, Operation ABLE
• Selma de Castro, Just A Start
• María José Sánchez Román, University of Nebraska Medical Center
• Natasha A. Kaushal, ECOG-ACRIN Cancer Research Group
• Timothy B. Creedon, U.S. Department of Health and Human Services
• Rajan A. Sonik, Brandeis University
• Catherine Rodriguez Quinerly, Massachusetts Department of Mental Health
• Ora Nakash, Smith CollegeFollow
• et al, various instituions

Document Type

Article

Publication Date

4-2025

Publication Title

Health Services Research

Abstract

Objective

To understand whether and how primary care providers and staff elicit patients' past experiences of healthcare discrimination when providing care.

Data Sources/Study Setting

Twenty qualitative semi-structured interviews were conducted with healthcare staff in primary care roles to inform future interventions to integrate data about past experiences of healthcare discrimination into clinical care.

Study Design

Qualitative study.

Data Collection/Extraction Methods

Data were collected via semi-structured qualitative interviews between December 2018 and January 2019, with health care staff in primary care roles at a hospital-based clinic within an urban safety-net health system that serves a patient population with significant racial, ethnic, and linguistic diversity.

Principal Findings

Providers did not routinely, or in a structured way, elicit information about past experiences of healthcare discrimination. Some providers believed that information about healthcare discrimination experiences could allow them to be more aware of and responsive to their patients' needs and to establish more trusting relationships. Others did not deem it appropriate or useful to elicit such information and were concerned about challenges in collecting and effectively using such data.

Conclusions

While providers see value in eliciting past experiences of discrimination, directly and systematically discussing such experiences with patients during a primary care encounter is challenging for them. Collecting this information in primary care settings will likely require implementation of multilevel systematic data collection strategies. Findings presented here can help identify clinic-level opportunities to do so.

Keywords

healthcare disparities, health equity, primary care, qualitative research, racial/ethnic differences in health, health care

Volume

60

First Page

e14373

Rights

Licensed to Smith College and distributed CC-BY 4.0 under the Smith College Faculty Open Access Policy.

Version

Author's Accepted Manuscript

Recommended Citation

Cortés, Dharma E.; Progovac, Ana M.; Lu, Frederick; Lee, Esther; Tran, Nathaniel M.; Moyer, Margo A.; Odayar, Varshini; Rodgers, Caryn R.R.; Adams, Leslie; Chambers, Valeria; Delman, Jonathan; Delman, Deborah; de Castro, Selma; Sánchez Román, María José; Kaushal, Natasha A.; Creedon, Timothy B.; Sonik, Rajan A.; Rodriguez Quinerly, Catherine; Nakash, Ora; and al, et, "Eliciting Patient Past Experiences of Healthcare Discrimination as a Potential Pathway to Reduce Health Disparities: A Qualitative Study of Primary Care Staff" (2025). School for Social Work: Faculty Publications, Smith College, Northampton, MA.
https://scholarworks.smith.edu/ssw_facpubs/82