Perceived Discrimination in the Healthcare Setting and Medical Mistrust: Findings from the Health Information National Trends Survey, 2022.

Background: Perceived discrimination and medical mistrust are barriers to care that impact both individual and population health.

Objective: This study aims to characterize the prevalence of perceived racial or ethnic discrimination in healthcare as well as mistrust in the medical system and explore their associations with race and ethnicity.

Design: Cross-sectional study of nationally representative data from the Health Information National Trends Survey (fielded March-November 2022).

Participants: Non-institutionalized US adults (n = 6252; weighted household response rate = 28.1%).

Main Measures: Outcomes were perceived racial or ethnic discrimination in healthcare and medical mistrust. The independent variable was race or ethnicity.

Key Results: An estimated 7.1% (95%CI, 6.0-8.2%) of the US adult population report experiencing racial or ethnic discrimination in healthcare. Perceived discrimination is most prevalent among individuals identifying as Black (18.8% [95%CI, 14.8-22.8%]), followed by Asian (15.1% [95%CI, 4.8-25.4%]) and Hispanic individuals (9.8% [95%CI, 7.4-12.2%]). Medical mistrust is reported by an estimated 62.3% (95%CI, 60.4-64.2%) of the US population, with the highest prevalence among Hispanic (68.9% [95%CI, 64.8-73.0%]) and Black individuals (67.8% [95%CI, 62.7-72.9]). In a multivariable Poisson regression, the prevalence of medical mistrust was significantly higher among Hispanic (adjusted prevalence ratio (aPR), 1.12 [95%CI, 1.04-1.21]) and Black (aPR, 1.10 [95%CI, 1.01-1.20]) respondents relative to White respondents, after adjusting for age, sex, and sexual orientation. Additionally, when adjusting for race and ethnicity, age, sex, and sexual orientation, medical mistrust was significantly more prevalent among those reporting perceived discrimination (aPR, 1.38 [95%CI, 1.30-1.47]).

Conclusions: Perceived discrimination in healthcare and medical mistrust are prevalent at the national scale, with racial and ethnic groups of color bearing the brunt. System-wide efforts are needed to improve health equity for marginalized patient populations.