Minority Patients With Eye Diseases Report Less Respect During Treatment

Brian C. Stagg, MD

Health disparities in the treatment of eye diseases often leads to disparities in vision outcomes, with conditions such as poor vision and blindness affecting people from racial and ethnic minority backgrounds disproportionately.

Led by Brian C. Stagg, MD, John Moran Eye Center, Department of Population Health Sciences, The University of Utah, a team of investigators evaluated the frequency that patients in racial and ethnic minority groups feel they were treated with respect and asked about their opinions/beliefs about medical care by their clinician, in comparison to non-Hispanic White participants.

Accordingly, findings from the study showed patients in racial and ethnic minority populations reported feeling less respected by healthcare professionals, which remained after adjustments for self-reported gender, age, and education.

Methods

Participants in the 2017 National Health Interview Survey (NHIS). self-reported having eye diseases, including macular degeneration, diabetic retinopathy, glaucoma, and cataracts and were included in the study population.

Additionally, the NHIS included information on social determinants of health, such as gender, age, education, race, and ethnicity. The age categories included ages 18 - 39 years, 40 - 64 years, 65 - 74 years, 75 - 84 years, and 85 years and older. Race was self-reported as White, Black, Asian, and other/multiple races, while ethnicity included either non-Hispanic or Hispanic.

The outcome variables assessed asked how often health care providers asked for opinions or beliefs on medical care, as well as how often were patients treated with respect. Response options included “always,” “most of the time,” “some of the time,” and “none of the time.”

A multivariable logistic regression model was used to evaluate the association of minority status with self-reported “always” treated with respect by clinicians and self-reported “always” being asked about opinions surrounding medical care.

Findings

The total study population for analysis included 5343 individuals with vision-threatening eye diseases, of which 3296 (61.69%) identified as women and most participants (98.34) were aged ≥40 years.

Data show participants from racial and ethnic minority backgrounds comprised 21.11% of the study population. The most prevalent vision-threatening eye condition was cataracts (n = 474, 89%).

In the multivariable model, patients in a racial and ethnic minority group were less likely to state they were treated with respect by their clinician compared with non-Hispanic White patients (AOR, 0.77; 95% CI, 0.61 - 0.97, P = .03).

For those not in racial and ethnic minority groups, 79.21% (95% CI, 74.87% - 83.54%) reported they were always treated with respect, compared with 74.68% (95% CI, 69.32 - 80.04%) of those in racial and ethnic minority groups.

Data show a minority of participants had 66% higher odds of reporting being asked about their beliefs (AOR, 1.66; 95% CI, 1.39 - 1.98, P <.001). For all patients, asking about opinions or beliefs was associated with a 5.8 times higher odds of reporting being treated with respect (AOR, 5.80; 95% CI, 4.35 - 7.74; P <.001).

Takeaways

Overall, Stagg and colleagues noted that the findings suggested when clinicians ask about opinions or beliefs of their patients who are in racial and ethnic minority groups, they may be more likely to feel they are treated with respect.

“Future work on the drivers that contributed to racial and ethnic minority patients’ reporting not being treated with respect but being asked about their opinions/beliefs might help clinicians gain insight on how to communicate with their patients and further address these drivers,” they wrote.

The study, “Perceptions of Respect From Clinicians by Patients in Racial and Ethnic Minority Groups With Eye Disease,” was published in JAMA Ophthalmology.