The Link Between Perceived Racism and Health Services Utilization Among Older Adults
Bibliographic record
Abstract
OBJECTIVES: To understand the link between perceived racial/ethnic discrimination among older adults and 2 health service utilization processes: (1) visiting health care providers or emergency room (ER), and (2) repeated visits after the first encounter. METHODS: Analysis of 2021 Commonwealth Fund International Health Policy Survey of Older Adults-a nationally representative, self-reported, and cross-sectional survey from Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom, and the United States. We used a 2-part multivariable hurdle model. RESULTS: Perceived discrimination was associated with 18% reduced odds of visiting at least 1 primary care provider (OR: 0.82; 95% CI: 0.68-0.99). Among those who have visited at least 1 provider, those who perceived discrimination were more likely to visit different providers when compared with those who did not (RR: 1.06; 95% CI: 1.01-1.11). Perceived racism was associated with first (OR: 1.13; 95% CI: 1.01-1.27) and frequent (RR: 1.14; 95% CI: 1.01-1.29) ER visits. CONCLUSIONS: Perceived racial discrimination is linked with higher health service utilization among older adults in high-income countries. POLICY IMPLICATIONS: A multilevel policy response that includes workforce sensitization and diversification, system transparency and accountability, and addressing structural barriers to accessing health care is warranted.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".