Immigrant perceptions of discrimination in health care: the California Health Interview Survey 2003

The 2002 Institute of Medicine (IOM) report Unequal Treatment summarized research on racial and ethnic disparities in health care defined as "racial or ethnic differences in the quality of healthcare that are not due to access-related factors or clinical needs, preferences, and appropriateness of intervention."1 The report documented extensive disparities in health care; however, the mechanisms underlying these disparities are less well understood and are likely multifactorial. One possible mechanism may be systematic bias or discrimination within the healthcare context, which would decrease quality of care, or patient perceptions of discrimination, which would influence care-seeking behavior and adherence. Studies have documented an association between perceptions of racial/ethnic discrimination and a delay in seeking treatment,2-4 lower adherence to treatment regimens, 4,5 and lower rates of follow up.4 The great majority of research on perceptions and experiences of discrimination in healthcare has focused on blacks,3,6-21 and there is a "relative paucity" of research on other groups.