Self-perception of aging and perceived medical discrimination

Abstract

Background: Individuals who perceive medical discrimination often face adverse consequences. How individuals perceive their own aging experiences may influence perceived medical discrimination due to age by generating expectations that they will receive poor treatment from clinicians, which may be amplified for individuals who also perceive discrimination because of race. This study explored the relationship between self-perceptions of aging (SPA) and perceived medical discrimination due to age, race, and other reasons.

Methods: We used three waves (2008, 2012, 2016) from the nationally representative Health and Retirement Study (HRS) data. Our sample included 10,188 community-residing individuals aged 51 and over. SPA were measured by two domains: positive SPA and negative SPA. Multinomial logistic regression that adjusted for demographic, health characteristics, and year-fixed effects was conducted to estimate the relationship between SPA and categories of perceived medical discrimination (age, race, age and race, and other).

Results: Approximately 11% of the population perceived discrimination because of age or race in the medical setting from 2008 to 2016. Older adults who had a positive SPA were 15% [Adjusted relative risk ratio (ARR): 0.85, 95% CI: 0.79-0.91], 13% [ARRR: 0.87, 95% CI: 0.76-1.00], and 20% [ARRR: 0.80, 95% CI: 0.74-0.88] less likely to experience perceived medical discrimination due to age, race, and the intersection of age and race, respectively, than those who did not, holding other factors constant. Those who held a negative SPA were 38% [ARRR: 1.38, 95% CI: 1.28-1.48] more likely to report perceived medical discrimination due to age and 12% [ARRR: 1.12, 95% CI: 1.03-1.21] more likely to report perceived medical discrimination due to other reasons.

Conclusions: Holding a positive perception of aging may help reduce perceived medical discrimination because of age and race, which may in turn improve communication and lead to timely and appropriate treatment.

Keywords: ageism; intersection; medical environment; perspective of age.