Afrolatinx Healthcare Satisfaction

Background and Purpose: Anti-Black racism, colorism and racialization interrupts and prevents Black diasporic groups in the United States from experiencing quality healthcare. Anti-Black healthcare provider bias is linked to negative healthcare experiences among Black healthcare consumers. Due to the essentializing and homogenization of Latinx populations in the United States, AfroLatinx communities are often overlooked in healthcare equity research. Evidence suggests AfroLatinxs experience barriers to healthcare. When they do seek care, AfroLatinxs are more likely to have negative healthcare experiences than their white-Latinx counterparts, such as having to self-advocate for care and being rushed by providers. Such experiences would negatively impact how satisfied AfroLatinxs are with their healthcare. However, no study has yet to examine AfroLatinx levels of healthcare satisfaction. This study seeks to 1) assess AfroLatinx adult’s levels of healthcare satisfaction compared to white-Latinx adults and 2) test whether visiting a mental health professional better or worsens AfroLatinx adults’ healthcare satisfaction.

Methods: This study extracted extant data from the National Health Interview Survey (2010-2018). The total Latinx adult sample (N= 27,337) includes respondents who self-classified as Black (n=948) and white (n=26,389). Respondents reported whether they visited a mental healthcare professional in the past year (0=no, 1=yes) and how satisfied they were with their healthcare in the past year (0=satisfied, 1=dissatisfied). Descriptive statistics described the respondents’ sociodemographic characteristics. Multivariate statistics, specifically logistic regressions, produced odds ratio estimates for 1) the main effects of race and visiting a mental health professional on healthcare satisfaction, 2) the interaction effect of race and visiting a mental health professional on healthcare satisfaction. Each model adjusted for age, sex, nativity, nationality, health coverage, poverty status, employment, language, psychological distress, U.S. region, and survey year. Predicted probabilities were produced to interpret the odds ratios of interest.

Results: The main effect of race was significant. When compared to white-Latinxs, AfroLatinx adults had significantly higher odds of being dissatisfied with their healthcare (aOR=1.60, 95% CI 1.06-2.44). Though the main effect of visiting a mental health professional was not significant, it significantly interacted with race. AfroLatinx adults who visited a mental health professional in the past year had higher odds of being dissatisfied with their healthcare (aOR=7.37, 95% CI [2.73-19.83]). The probability of AfroLatinxs who visited a mental health professional being dissatisfied with their healthcare was 30%, 24% higher than white-Latinxs.

Conclusion and Implications: There is racial inequity in the quality-of-care Latinx adults receive in the United States. AfroLatinx adults who visited a mental health professional are five times more likely to be dissatisfied with their healthcare than white-Latinx adults. Given that anti-Black implicit bias in healthcare contributes to poorer service delivery, social work practitioners and researchers should direct attention to providing structural and culturally responsive care for AfroLatinxs. It is recommended they collaborate with care teams and AfroLatinx communities to collect multidimensional race data that is inclusive of AfroLatinxs and to collect qualitative data to understand how anti-Black racism shapes AfroLatinx healthcare experiences.