skip to main content
US FlagAn official website of the United States government
dot gov icon
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
https lock icon
Secure .gov websites use HTTPS
A lock ( lock ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

Explore Research Products in the PAR
It may take a few hours for recently added research products to appear in PAR search results.


  • NSF Public Access
  • Search Results
  • Gender Identity-, Race-, And Ethnicity-Based Discrimination in Access to Mental Health Care: Evidence from an Audit Correspondence Field Experiment
Title: Gender Identity-, Race-, And Ethnicity-Based Discrimination in Access to Mental Health Care: Evidence from an Audit Correspondence Field Experiment
Transgender people, African Americans, and Hispanics face mental health disparities. While mental health care can help, minoritized groups could face discriminatory barriers in accessing it. Discrimination may be particularly pronounced in mental health care because providers have more discretion over accepting patients. Research documents discrimination broadly, including in access to health care, but there is limited empirical research on discrimination in access to mental health care. We provide the first experimental evidence, from a correspondence audit field experiment (“simulated patients” study), of the extent to which transgender and non-binary people, African Americans, and Hispanics face discrimination in access to mental health-care appointments. We find significant discrimination against transgender or non-binary African Americans and Hispanics. We do not find evidence of discrimination against White transgender and non-binary prospective patients. We are mostly inconclusive as to whether cisgender African Americans or Hispanics face discrimination, except we find evidence of discrimination against cisgender African American women.  more » « less
Award ID(s):
2046642
PAR ID:
10505049
Author(s) / Creator(s):
; ; ; ;
Publisher / Repository:
The University of Chicago Press Journals
Date Published:
Journal Name:
American Journal of Health Economics
ISSN:
2332-3493
Page Range / eLocation ID:
000 to 000
Subject(s) / Keyword(s):
mental health care transgender racial discrimination audit therapy
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
More Like this
  1. ; ; (, Social Science & Medicine)
    While much of the transgender health literature has focused on poor health outcomes, less research has examined how trans people find reliable information on, and actually go about accessing, gender-affirming healthcare. Through qualitative interviews with creators of trans technologies, that is, technologies designed to address problems that trans people face, we found that digital technologies have become important tools for proliferating access to gender-affirming care and related health information. We found that technologists often employed different processes for creating their technologies, but they coalesced around the goal of enabling and increasing access to gender-affirming care. Creators of trans health technologies also encountered precarious conditions for creating and maintaining their technologies, including regional gaps left by national resources focused on the US east and west coasts. Findings demonstrated that trans tech creators were motivated to create and maintain these technologies as a means of caring for one another and forming trans communities in spite of the precarious conditions trans people face living under systemic oppression. 
    more » « less
  2. ; ; ; ; ; (, Pediatrics)
    OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has fueled xenophobia against Chinese Americans. We examined the rates of 6 types of COVID-19 racism and racial discrimination experienced by Chinese American parents and youth and the associations with their mental health. METHODS: We recruited a population-based sample of Chinese American families to participate in this self-reported survey study conducted from March 14, 2020, to May 31, 2020. Eligible parent participants identified as ethnically/racially Chinese, lived in the United States, and had a 4- to 18-year-old child; their eligible children were 10 to 18 years old. RESULTS: The sample included 543 Chinese American parents (mean [SD] age, 43.44 [6.47] years; 425 mothers [78.3%]), and their children (N = 230; mean [SD] age, 13.83 [2.53] years; 111 girls [48.3%]). Nearly half of parents and youth reported being directly targeted by COVID-19 racial discrimination online (parents: 172 [31.7%]; youth: 105 [45.7%]) and/or in person (parents: 276 [50.9%]; youth: 115 [50.2%]). A total of 417 (76.8%) parents and 176 (76.5%) youth reported at least 1 incident of COVID-19 vicarious racial discrimination online and/or in person (parents: 481 [88.5%]; youth: 211 [91.9%]). A total of 267 (49.1%) parents and 164 (71.1%) youth perceived health-related Sinophobia in America, and 274 (50.4%) parents and 129 (56.0%) youth perceived media-perpetuated Sinophobia. Higher levels of parent- and youth-perceived racism and racial discrimination were associated with their poorer mental health. CONCLUSIONS: Health care professionals must attend to the racism-related experiences and mental health needs of Chinese Americans parents and their children throughout the COVID-19 pandemic via education and making appropriate mental health referrals. 
    more » « less
  3. ; ; ; ; ; ; (, ACM)
    Despite high incidence of depression, anxiety, and post traumatic stress disorder, stigma and lack of access to culturally responsive behavioral health care resources prevents many Native Americans (NA) from seeking care. However, the rise of culturally-responsive in-person and digital behavioral health resources for NA communities provides new opportunities to address these longstanding health equity issues. The major challenge is helping people in NA communities find these meaningful resources and helping anchor institutions understand how resources are being sought and utilized to support more responsive internal programming. In this context, we have partnered with Hopi Behavioral Health Services (HBHS) to design the Resilience Resource Database to digitally disseminate mental and behavioral health resources. This paper presents initial findings that have resulted from the initial stage of an iterative participatory design process with HBHS. 
    more » « less
  4. (, Social science & medicine)
    Among LGBTQ people, those who are gender nonconforming (GNC) may be at heightened risk of both discrimination and underutilization of healthcare—yet little is known about what happens during healthcare encounters to compel GNC individuals to continue or avoid seeking future care. This study qualitatively examines the healthcare experiences of a racially diverse sample of 34 adult LGBTQ cis women, transgender men, and nonbinary individuals in a metropolitan area of the United States who do not conform to dominant biomedical schemas of sex and gender. GNC individuals experience embodied disruption in medical settings when patients are mis/recognized; providers respond to disruption in ways that further distress patients. Broadly, participants report similar experiences across racial and gender identities, but patients manage disruption somewhat differently depending on their embodied positions to gender norms. This study contributes to literature of stress, stigma, and sex, gender, and sexuality within medicine by illuminating how stigmatizing healthcare interactions deter LGBTQ individuals from seeking healthcare. Findings point to the importance of considering both structural factors and embodied visibility in future research addressing how stigma and discrimination manifest within health settings to disadvantage LGBTQ groups. 
    more » « less
  5. (, Open Access Government)
    Allergic asthma and the legacy of structural racism on the African American urban communities Asthma is a chronic inflammatory disease that is characterized by bronchial hyperreactivity (wheezing due to narrowing of the airways) and it disproportionately affects African Americans. Allergic asthma is a chronic inflammatory disease that is characterized by bronchial hyperreactivity and elevation of allergic antibodies. In the United States approximately 25 million people are affected by this disease with a death toll of about 3,500 per year. African American children are at least 10 times more likely to die from asthma than their white counterparts. Collectively, the mortality rate in the African American population is double the rate in Caucasians (21.8 vs 9.5 death rate per million). The 2005 Agency for Healthcare Research and Quality's report on the Disparity in Health Care among African Americans and Ethnic minority reported allergic asthma as the second largest disparity in the quality of health care for them versus Caucasians. Today, health disparity in asthma persists and several hypotheses for this disparity have been proposed. 
    more » « less
  • Citation Formats
  • MLA
  • APA
  • Chicago
  • BibTeX
  • Save / Share this Record
  • Send to Email