Unconscious biases: Racial microaggressions in American Indian health care

Melissa L Walls, John Gonzalez, Tanya Gladney, Emily C Onello

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Purpose: This article reports on the prevalence and correlates of microaggressive experiences in health care settings reported by American Indian (AI) adults with type 2 diabetes mellitus (T2DM). Methods: This community-based participatory research project includes two AI reservation communities. Data were collected via in-person article-and-pencil survey interviews with 218 AI adults diagnosed with T2DM. Results: Greater than one third of the sample reported experiencing a microaggression in interactions with their health providers. Reports of microaggressions were correlated with self-reported history of heart attack, worse depressive symptoms, and prior-year hospitalization. Depressive symptom ratings seemed to account for some of the association between microaggressions and hospitalization (but not history of heart attack) in multivariate models. Conclusions: Microaggressive experiences undermine the ideals of patient-centered care and in this study were correlated with worse mental and physical health reports for AIs living with a chronic disease. Providers should be cognizant of these subtle, often unconscious forms of discrimination. (J Am Board Fam Med 2015;28:231-239.)

Original languageEnglish (US)
Pages (from-to)231-239
Number of pages9
JournalJournal of the American Board of Family Medicine
Volume28
Issue number2
DOIs
StatePublished - Mar 1 2015

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Racism
North American Indians
Delivery of Health Care
Type 2 Diabetes Mellitus
Hospitalization
Myocardial Infarction
Community-Based Participatory Research
Depression
Patient-Centered Care
Mental Health
Chronic Disease
Interviews
Health
Unconscious (Psychology)

Keywords

  • Cross-Cultural care
  • Patient-Centered care
  • Populations
  • Underserved

Cite this

Unconscious biases : Racial microaggressions in American Indian health care. / Walls, Melissa L; Gonzalez, John; Gladney, Tanya; Onello, Emily C.

In: Journal of the American Board of Family Medicine, Vol. 28, No. 2, 01.03.2015, p. 231-239.

Research output: Contribution to journalArticle

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