Relationships between health and perceived unequal treatment based on race : results from the 2002 North Carolina BRFSS survey

SCHS Studies A Special Report Series by the State Center for Health Statistics 1908 Mail Service Center, Raleigh, N.C. 27699-1908 North Carolina Public Health Www.schs.state.nc.us/SCHS/ No. 144 September 2004 Relationships between Health and Perceived Unequal Treatment Based on Race: Results from the 2002 North Carolina BRFSS Survey by Ziya Gizlice, Ph.D. 1 Emmanuel M. Ngui, Ph.D 2 ABSTRACT Objectives: Previous studies suggest that racism prejudice or discrimination based on race - is an important underlying detenninant of health disparities and quality of life in the United States. How¬ ever, few studies have quantitatively measured the effect of racism on health. This study examines the relationship between health status and perceived treatment based on race among North Carolina adults. By “treatment” we mean how people are treated by others, not medical treatment. Methods: The North Carolina Behavioral Risk Factor Surveillance System (BRFSS) is a multistage, random-digit dialing, statewide telephone survey of non- institutionalized adult residents age 18 and older. In 2002 the North Carolina BRFSS included a six-question “Reactions to Race” module and conducted 6,748 interviews. This study used data from this BRFSS module. Results: Approximately 6.5 percent of North Carolina adults reported having emotional upset and/or physical symptoms due to treatment based on race in the past 30 days and 10 percent reported un¬ equal experiences when seeking health care compared to people of other races. After adjusting for the other demographic characteristics, the odds of African Americans reporting emotional upset and / or physical symptoms due to treatment based on race (Odds Ratio=5.30, p < 0.001 ) and reporting worse experiences than other races when seeking health care (Odds Ratio=4.92, p < 0.001 ) were much greater than those for whites. Respondents who reported having emotional upset and/or physical symptoms due to treatment based on race, or those respondents who reported experiences worse than other races when seeking health care, had significantly lower quality of life and higher rates of chronic condi¬ tions and health risks. These results persisted after controlling for demographic characteristics. Conclusions: Perceived unequal treatment based on race is associated with lower quality of life and with higher rates of chronic diseases and risk behaviors and conditions. African Americans are far more likely than whites to report being treated worse than other races when seeking health care and to report having emotional upset and/or physical symptoms due to treatment based on race. 'Slate Center lor Health Statistics, North Carolina Division of Public Health г Medical College of Wisconsin, Department of Pediatrics NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES