Racial and ethnic minorities face significant health disparities as they are less likely to receive preventive health services, receive lower-quality care and have worse health outcomes for many chronic conditions than White people (Hostetter, Klein, 2018). Thus, it is important to analyze what psychological and social factors affect these populations and how they contribute to healthcare engagement. One psychological correlate that has not been focused on is self-rated health. Self-rated health has mainly been analyzed for its relationship with personality and physiological factors but little research has focused on how it influences seeking medical care. Fair/poor self-rated health was found to be associated with greater distrust in the health care system in a primarily White sample (Armstrong et al., 2006). In this way, self-rated health impedes health as it is associated with failing to follow physician’s advice, failure to seek medical care when they needed it and delays in seeking care (LaVeist, Isaac, & Williams, 2009). In a majority Hispanic/Latinx and White sample, self-rated health was significantly correlated with better patient provider relationships and there was no significant difference in self-rated health among races (Kamimura et al., 2020).
The aim of this study was to investigate how an individual’s self-rated health and race/ethnicity influences the relationship between feelings of content and the frequency at which one sees their primary care provider (PCP) for a checkup. We hypothesized that racial/ethnic minorities who rate their health higher, would see their PCP for a health visit less often when they are more content. Using Amazon’s Mechanical Turk, the researchers administered a questionnaire to 1210 participants measuring demographic information, self-rated health, number of visits to their PCP per year and the World Health Organization Quality of Life- Feeling or Experiences Subscale. Our study used one item from the Feeling or Experiences Subscale referring to how often the participant felt content over the past two weeks. A moderated moderation using Hayes’(2020) PROCESS macro was conducted. There was a significant main effect of self-rated health on frequency of seeing their PCP, b = 0.12, p < .001. Additionally, there was a significant main effect on the difference between how many Black participants compared to White participants went to see their PCP, b = -0.21, p =.0265. There was a significant three way interaction between feelings of content, self-rated health and being Black on seeing their PCP for a checkup (Figure 1). When a Black individual’s self-rated health is low, they are less likely to visit their PCP for a checkup when they are more content, b = -0.07, p =.0421.
These results significantly add to the literature as it provides more clarity on how individuals perceive their health affects the rate in which they see their PCP. Our hypothesis was supported for White participants as feelings of content and self-rated health did not affect the rate in which they sought medical attention. However, our hypothesis did not support all racial/ethnic minorities outside of Black participants as feelings of content and self-rated health did not moderate the relationship between feeling content and seeing their PCP. These results are similar to prior research as African Americans have been studied to delay or avoid seeking care due to discriminatory and biased past health care experiences. If a Black individual rates their health as high, they are less likely to go to the doctor due to lack of trust in health professionals and the health care system. More research needs to be conducted in other racial/ethnic minorities to identify what factors influence seeking medical care. Identifying these experiences and perceptions of health in marginalized populations can help advance the patient-provider relationship and improve the importance of maintenance of good health.
Kristina Hood, PhD
Is Part Of
VCU Graduate Research Posters