Healthcare Discrimination May Occur Based on Socioeconomic Resources

In a survey, about one in five patients with cancer reported receiving unfair treatment related to their healthcare, according to an abstract from the 2021 American Society of Clinical Oncology (ASCO) Quality Care Symposium.

The study used data from a nationwide survey distributed in December 2020 by the Patient Advocate Foundation (PAF), a non-profit providing case management and financial aid to individuals with chronic illness. The survey was sent those individuals aged 19 years or older with current or previous cancer treatment who had received PAF services from July 2019 to April 2020. In total, 429 patients with cancer responded.

Most survey respondents were female (73%) and about one-third were Black, Indigenous, or people of color (BIPOC). The most commonly reported cancers were hematologic (33%) and breast (33%).

Of the 20% of respondents who reported having received unfair treatment, more than half (56%) reported this treatment was from a doctor, nurse, or healthcare provider. Half (51%) reported unfair treatment from an insurance company, 38% from the healthcare system, and 14% from a pharmacist.

When asked why they were treated unfairly, responses that unfair treatment was due to race/ethnicity, sex, or sexual/gender orientation were uncommon. Instead, the most common reasons for unfair treatment were insurance status (51%), disease or condition (45%), and income (35%). However, 51% of BIPOC respondents reported a high mistrust in medical providers.

The researchers compared responses among those who reported fair treatment and those who reported unfair treatment. Respondents reporting unfair treatment were more likely to be unemployed/other (28% vs. 11%), have privately insurance (38% vs. 27%), earn less than $23,000 annually (40% vs 25%), have three or more comorbidities (40% vs. 23%), and report more mistrust in medical providers (53% vs. 27%).

Based on these results, study researchers wrote that “healthcare-associated discrimination may occur based on socioeconomic resources,” and that this finding warrants further evaluation.