The Impact of Daily Discrimination on Health and Social Service Use Among Minority Family Caregivers of Older Adults

Background and Purpose: Research on health service has shown that language barriers and cultural preferences for informal support play a role in the low use of formal services among racially and ethnically diverse family caregivers. Despite the documented reality that racially and ethnically diverse people experience discrimination in daily life, the extent to which discrimination plays a role in the patterns of how caregivers use health and social services has yet to be explored. This paper examines the possibility that longstanding and frequent experiences of daily discrimination are important factors in the decisions by caregivers to delay service. The purpose of this study is to explore the effects of experiences of daily discrimination faced by caregivers from minority families on their use of health and social services when caring for older adults in Canada.

Methods: A cross-sectional survey was conducted with 102 racial- and ethnic-minority family caregivers of older adults with chronic illnesses in Montreal, Canada. The sample was drawn from communities and religious organizations, informal referrals, social service providers, and on site recruitment by the principal investigator. Bivariate analysis and hierarchical multiple regression were conducted by using SPSS 24. 

Results: Among 102 participants, the majority of minority family caregivers were female, and immigrants, had a mean age of 60. Overall participants reported a medium level of experience of discrimination in daily life (M = 15.5, SD = 3.93). Results of the hierarchical regression analysis show that caregivers with higher levels of care demand, b =.55, p = .00, 95% CI [.19, .92] and with lower levels of French proficiency, b = -2.45, p = .01, 95% CI [-4.40, -.50] were significantly associated with more health and social service use. However, informal support and experience of discrimination were no longer statistically associated with health and social service uses.

Conclusion and Implications: Findings of this current study suggest that minority family caregivers experience discrimination in daily life, which affects their trust in and expectations of health and social service providers. While previous experiences may deter some from accessing services, increased caregiving demand eventually necessitates service use for many. Within this context, it is integral for service providers to respond sensitively to the needs of ethnically and racially diverse caregivers so that previous experiences of discrimination are no replicated.