Disparities in Experience with Culturally Competent Care and Satisfaction with Care by Sexual Orientation.

Ning Hsieh, Inna Mirzoyan
Author Information
  1. Ning Hsieh: Department of Sociology, Michigan State University, East Lansing, Michigan, USA.
  2. Inna Mirzoyan: Department of Sociology, Michigan State University, East Lansing, Michigan, USA.

Abstract

Prior studies have identified health care providers' lack of cultural competency as a major barrier to care among sexual minority individuals. However, little is known about disparities in experience with culturally competent care by sexual orientation at the population level. This study assessed experiences with culturally competent care and satisfaction with care across sexual orientation groups in the United States. We analyzed nationally representative data from the 2017 National Health Interview Survey ( = 21,620) with ordinal logit regression models and compared six aspects of health care experiences across sexual orientation groups. These were: preferences for and frequencies of seeing health care providers who understand or share their culture; perceived experiences of being treated with respect by providers and providers asking about their beliefs and opinions; access to easily understood health information from providers; and satisfaction with received care. Relative to heterosexual men, gay men were more likely to consider it important for providers to understand or share their culture (odds ratio [OR] = 1.4,  < 0.05) and to have providers who ask for their opinions or beliefs about care (OR = 1.5,  < 0.01). Relative to heterosexual women, bisexual- and something else-identified women were less likely to report being treated with respect (ORs = 0.4-0.6, s < 0.01) and satisfaction with care (ORs = 0.5-0.6, s < 0.05). No statistical differences in health care experiences were found between other sexual minority groups and their heterosexual counterparts. Access to culturally competent care and satisfaction with care varied by sexual orientation and gender. Clinical practices should address the unique health care barriers faced by bisexual- and something else-identified women.

Keywords

References

  1. Am J Public Health. 2014 Feb;104(2):e95-e104 [PMID: 24328616]
  2. Med Anthropol Q. 2014 Dec;28(4):578-98 [PMID: 25196115]
  3. Health Aff (Millwood). 2010 Aug;29(8):1539-48 [PMID: 20576694]
  4. J Health Soc Behav. 2017 Jun;58(2):147-165 [PMID: 28661778]
  5. Health Serv Res. 2009 Apr;44(2 Pt 1):542-61 [PMID: 19040424]
  6. Am J Public Health. 2015 Sep;105(9):1831-41 [PMID: 26180976]
  7. LGBT Health. 2014 Dec;1(4):309-318 [PMID: 25568885]
  8. Am J Public Health. 2015 Aug;105(8):1552-8 [PMID: 26066963]
  9. Soc Sci Med. 2018 Jul;208:126-133 [PMID: 29803970]
  10. LGBT Health. 2016 Oct;3(5):342-9 [PMID: 27604053]
  11. Am J Public Health. 2015 Dec;105(12):e60-76 [PMID: 26469668]
  12. J Health Soc Behav. 2011 Jun;52(2):212-27 [PMID: 21490311]
  13. Soc Sci Med. 2018 Aug;211:352-358 [PMID: 30018025]
  14. Am J Public Health. 2010 Mar;100(3):489-95 [PMID: 20075319]
  15. Women Health. 2015;55(6):717-36 [PMID: 25909663]
  16. Soc Sci Med. 2012 Jul;75(1):208-16 [PMID: 22503834]
  17. Health Aff (Millwood). 2017 Oct 1;36(10):1786-1794 [PMID: 28971924]
  18. Health Aff (Millwood). 2015 Oct;34(10):1769-73 [PMID: 26438755]
  19. J Health Soc Behav. 2016 Sep;57(3):319-32 [PMID: 27601408]
  20. PLoS One. 2017 Jul 10;12(7):e0180544 [PMID: 28692659]
  21. Arch Sex Behav. 2019 Jan;48(1):225-242 [PMID: 29633061]
  22. Am J Public Health. 2015 Jun;105(6):1114-9 [PMID: 25880937]
  23. Popul Res Policy Rev. 2014 Aug;33(4):553-577 [PMID: 25382887]
  24. Med Care. 2019 Dec;57(12):e87-e95 [PMID: 31415342]
  25. Demography. 2019 Oct;56(5):1791-1825 [PMID: 31538315]
  26. Am J Public Health. 2016 Jun;106(6):1116-22 [PMID: 26985623]

Grants

  1. R01 AG061118/NIA NIH HHS

MeSH Term

Adult
Culturally Competent Care
Female
Healthcare Disparities
Humans
Male
Middle Aged
Patient Satisfaction
Sexual and Gender Minorities
United States

Word Cloud

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