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Nearly half of healthcare workers say a patient’s race affects quality of care


Workers have seen discrimination against patients, according to a Commonwealth Fund report. Black and Latino workers are more likely to say they’ve witnessed racism.

Patients are receiving disparate care based on their race, ethnicity or the language they speak, and many healthcare workers say they are also facing discrimination.

These are two of a host of sobering findings from a new report by the Commonwealth Fund. The report, released Feb. 16, offers more perspective on inequities in treatment that affect the quality of care.

Here are some of the key findings of the report.

Patients and advocacy

Regardless of race, a sizable number of healthcare workers say that a patient’s race has an impact on the quality of care. Nearly half of all healthcare workers (48%) say providers are more willing to accept a white patient’s self-advocacy than a Black patient who speaks up.

But notably, more than two-thirds of Black healthcare workers (68%) say providers weren’t as accepting when Black patients advocate for themselves. The report’s authors noted the 20-point difference in the response of Black healthcare workers was “one of the most striking findings.”

Patients and language

A patient’s preferred language also can play a role in the quality of their care.

A majority of healthcare workers (57%) said patients who speak Spanish, Chinese or languages other than English may not get the same quality in treatment as a patient who speaks English.

Again, though, there’s a noticeable difference in how some workers answered this question. Nearly three-quarters (72%) of Latino healthcare workers said there was a gap in treatment based on language.

Racism and patients

Nearly half of healthcare workers (47%) say they’ve witnessed racism or discrimination against a patient, while 45% said they had not, and 7% weren’t sure.

More than 1 in 3 healthcare workers (38%) say they have witnessed racism affect the quality of care that a patient receives. More than half of Black healthcare workers (55%) and nearly half of Latino health workers (49%) say they’ve seen racism hurt the care of a patient.

One-third of white patients (33%) say they’ve seen racism affect patient care, while 35% of Asian American and Pacific Islander workers said they’ve witnessed racism affect patient care.

Patients aren’t the only ones affected by racism aimed at patients. “Discrimination against patients also takes a serious toll on health care workers’ well-being,” the report states.

Seeing racism as a problem

More than half of all healthcare workers (52%) say they view racism against patients as either a major problem or a crisis. One in three (33%) call it a major problem, while 19% take it a step further and describe it as a crisis.

A quarter of all healthcare workers (25%) say it’s a minor problem, while 18% say racism against patients isn’t a problem. The remainder (5%) say they don’t know.

Workers and discrimination

Black and Latino healthcare workers were much more likely to report that they’ve suffered discrimination at the workplace.

More than half of Black workers (58%) and nearly half of Latino workers (49%) and Asian workers (44%) say they’ve endured discrimination.

Overall, less than one-third of healthcare workers say they have suffered discrimination at work, including 22% of white employees.

A sizable percentage of healthcare workers (44%) say they’ve witnessed racism against other healthcare employees. Black (56%) and Latino (55%) employees were the most likely to say they observed racism or discrimination against a healthcare worker. While there is a gap, 4 in 10 white healthcare workers say they’ve observed racism targeting a healthcare worker.

Fears of retaliation

A significant percentage of workers (42%) said they worry about negative consequences for reporting racism or discrimination in the workplace.

Again, the responses vary among racial groups. More than half of Black (55%), AAPI (54%) and Latino (51%) workers say they worry about retribution, compared to 37% of white employees.


The authors suggest several steps for health systems to take action to provide better care for patients and a better work environment for their employees.

Healthcare organizations should make it easy for workers to report racism and discrimination anonymously, the report states. Workers should be trained to spot discrimination, and organizations should create spaces to hear the concerns of patients and employees who are members of minority groups.

Healthcare organizations also need to take a hard look at their policies to see if they are leading to disparities in outcomes. Organizations should examine patient care for individuals who don’t speak English as a primary language to see if there are areas for improvement.

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