In its latest health access survey, the Colorado Health Institute (CHI) estimates 4.2% or 148,000 Coloradans who sought health care in 2021 reported being treated with less respect or lower quality care than others, with income being the most common reason (representing 58.3% of respondents) among people of all races.
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Of the 148,000 individuals who reported being treated disrespectfully, 35.2% (52,000 individuals) were people of color. An overwhelming majority of non-white respondents said that race (87%) or ethnic background or culture (89.2%) were the reasons.
CHI says the data suggests a need for the state’s health system to address racial discrimination. These sentiments around unfair treatment lead to health hazards and are associated with increased stress and poor health outcomes. In 2021, Black (5.4%) and Hispanic Coloradans (4.4%) were twice as likely than their white counterparts (2.3%) to skip care due to concerns about unfair treatment or consequences.
Disability and language were other commonly reported reasons patients believed they were treated with less respect than other people.
“People with disabilities are devalued in society overall,” said Julie Reiskin, Executive Director of Colorado Cross-Disability Coalition. “There’s a huge lack of disability cultural competency: Medical professionals often think their job is to fix us, and that fixing us might mean making us not disabled. I think disability cultural competency is a necessity, and that has to be done in conjunction with racial equity.”
Unfair treatment also extends to health insurers. According to a study published last year in the journal JAMA, the average Black patient spends, notably less than the average white patient. Black individuals were also found to visit the emergency more often than white individuals.
The Colorado Department of Health Care Policy and Financing (HCPF) released its Health Equity Plan in June to address health disparities and improve outcomes for the state’s Medicaid and Child Health Plan Plus members.
The plan focuses on measures to improve data collection around health inequity identification and health outcomes through culturally responsive care. State legislators passed a law earlier this year to develop training on culturally responsive care with a focus on intersectionality or taking into account the overlapping identities and experiences of patients to better understand and care for them.
CHI called on the state’s policymakers and health system to continue addressing racial discrimination in health care and restore the trust between people of color and providers. It advocated for more authentic community engagement, diversifying the health care workforce, and promoting relationship-centered care to meet those ends.