African American veterans; African-Americans; Discrimination; Discrimination in medical care; Health services accessibility; Healthcare; Outcomes; Veterans


Community-Based Research | Health Services Research | Inequality and Stratification | Medicine and Health | Public Health | Race and Ethnicity


The Institute of Medicine identified access to healthcare and race-based discrimination as important barriers to quality healthcare that contributes to health disparities. This study (1) describes African-American veterans’ perceptions of healthcare services and perceived discrimination in healthcare and (2) investigates the relationship between perceived discrimination and patient perceptions of care, satisfaction with healthcare, and health status. A convenience sample of 141 African-American veterans in Boston completed surveys from May to June 2006.

Respondents reported an average of 16 lifetime experiences of discrimination and over half recalled a situation when they experienced discrimination in healthcare. Modest ratings of perceived quality of care, and satisfaction with healthcare reflect areas for improvement. Perceived healthcare discrimination was negatively and significantly associated with satisfaction (p<0.001), perceived quality of care (p<0.01), and physical functioning (p<0.05). Policies eliminating discrimination in healthcare are needed to improve patient satisfaction, quality of care, and health outcomes of African- American veterans.