Privilege and Power in Health Care - Slides

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Unconscious Biases: Racial Microaggressions in American Indian Health Care

Purpose

This paper reports on the prevalence and correlates of microaggressive experiences in healthcare settings reported by American Indian (AI) adults with type 2 diabetes.

Methods

This community-based participatory research project includes two AI reservation communities. Data were collected via in-person paper-and-pencil survey interviews with 218 AI adults diagnosed with type 2 diabetes.

Results

Over 1/3 of the sample reported experiencing a microaggression in interactions with their health providers. Reports of microaggressions were correlated with self-reported history of heart attack, worse depressive symptoms, and prior year hospitalization. Depressive symptom ratings appeared to account for some of the association between microaggressions and hospitalization (but not history of heart attack) in multivariate models.

Conclusions

Microaggressive experiences undermine the ideals of patient-centered care and in this study were correlated with worse mental and physical health reports for American Indians living with a chronic disease. Providers should be cognizant of these subtle, often unconscious forms of discrimination.

Purchase full article at:   http://goo.gl/9hCKwg

By:   Melissa L. Walls, PhD,a John Gonzalez, PhD,b Tanya Gladney, PhD,c and Emily Onello, MDd

^bAssociate Professor, Department of Psychology, Bemidji State University. 202 Hagg-Sauer Hall, Bemidji, MN 56601

^cAssistant Professor, Department of Sociology and Criminal Justice, University of St. Thomas, Mail # 5021, 2115 Summit Ave. St. Paul, MN 55105-1096

^dAssistant Professor, Department of Family Medicine/Community Health. University of Minnesota Medical School-Duluth. 153 Smed, 1035 University Drive, Duluth, MN 55812

^aCorresponding Author: Associate Professor, Department of Biobehavioral Health and Population Sciences, University of Minnesota Medical School-Duluth, 1035 University Drive, 235 SMed, Duluth, MN 55812. Phone: 218+726+8367. FAX: 218-726-7559. Email: ude.nmu.d@sllawlm

  

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Microaggressions, Feelings of Difference & Resilience among Adopted Children with Sexual Minority Parents

Limited research exists about the unique experiences and possible marginalization of children with sexual minority parents. From a larger longitudinal project of diverse adoptive families, we examined cross-sectional data using mixed methods from interviews with 49 adopted children (M age = 8 years; 47 % female) in 27 two-father and 22 two-mother families. Using thematic analysis, we coded themes of awareness of difference, microaggressions, and resilience (i.e., coping and positive family conceptualizations). 

Children experienced "feeling different" and microaggressions from peers, but generally at a low to medium intensity and with neutral (not negative) emotion. More instances of resilience and positive family conceptualizations were reported than microaggressions or feelings of difference, suggesting that children develop positive perceptions of their family and navigate experiences of difference with resilience. 

Filling important gaps in the literature, we discuss implications of our results for practice and policy.

Via: http://ht.ly/SpG0t 

By: Farr RH1, Crain EE2, Oakley MK2, Cashen KK2, Garber KJ2.

• 1Department of Psychology, University of Kentucky, 012-B Kastle Hall, 171 Funkhouser Drive, Lexington, KY, 40506-0044, USA.
• 2University of Massachusetts Amherst, Amherst, MA, USA.