Data from the Robert Wood Johnson Foundation and the Urban Institute reveals how health care discrimination impacts people with disabilities’ experiences with health care, with four in 10 people with disabilities reporting being treated unfairly in medical settings, at work, or while accessing public benefits.
Overall, 32% of adults with disabilities say they have been treated unfairly because of their disability or other personal characteristics, a rate that far exceeds the experiences of adults without disabilities.
“Despite more than 30 years of laws banning discrimination against people with disabilities, unequal treatment persists,” Rachelle Tardy, senior program officer at the Robert Wood Johnson Foundation and liaison to the President’s Council on Disability and Philanthropy Forum, said in an emailed statement. “Achieving disability equality will require continued policy improvement and public and private investment in access and resources.”
These findings come shortly after the National Institutes of Health (NIH) designated people with disabilities as a population facing health disparities. While health disparities that affect individuals with disabilities are caused by a variety of factors, this RWJF/Urban Institute report shows how health care discrimination may play a role.
The researchers looked at 2022 data from the Urban Institute’s Happiness and Basic Needs Survey, asking respondents ages 18 to 64, with and without disabilities, about their experiences in health care settings, at work, and when applying for public benefits.
Overall, 40 percent of people with disabilities say they have been treated unfairly in one of these three situations, compared to just 18 percent of people without disabilities who report the same.
Looking specifically at health care, 32 percent of people with disabilities said they had been treated unfairly because of their disability or other personal characteristics, compared with 10 percent of people without disabilities.
Fourteen percent of disabled respondents perceived discrimination to be because of a specific disability or health condition. Another 14 percent said discrimination was because of weight, 12 percent said it was because of type of insurance, 11 percent said it was because of gender/gender identity/sexual orientation, 10 percent said it was because of race/ethnicity/national origin/language preference, and 9 percent said it was because of income or education.
These figures far exceed those reported by people without disabilities. For example, 11 percent of people with disabilities reported discrimination based on sex, gender identity, or sexual orientation, compared to only 3 percent of people without disabilities.
In other words, people with disabilities were more likely to report unfair treatment than people without disabilities, even when the discrimination had nothing to do with their disability or health status.
Not surprisingly, racial disparities played a role: Black and Hispanic people with disabilities were more likely than White people with disabilities to report being treated or judged unfairly in each of the situations surveyed because of their race, ethnicity, national origin, or native language.
This level of discrimination has consequences: For 71 percent of adults with disabilities who reported being treated unfairly in a medical setting, the experience discouraged them from seeking medical care. Nearly half delayed (54 percent) or did not seek medical care at all (50 percent) because of the negative experience.
Access to the workplace and public benefits was also affected, with people feeling they should look for alternative employment or delaying or not receiving public benefits to which they are entitled. While not specific to discrimination in health care settings, these findings may indicate issues with key social determinants of health, with downstream implications for individual well-being.
“These findings suggest that experiences of unfair treatment are common among people with disabilities, leading to disruptions to health care and employment, and delays in receiving public benefits that help meet basic needs,” Dulce Gonzalez, a research associate at the Urban Institute, said in an emailed press release.
“Addressing the structural barriers and biases that undermine the health and well-being of people with disabilities will require intentional and sustained responses from the public and private sectors in partnership with people with disabilities.”
Discrimination based on any factor or personal characteristic is a symptom of serious health care inequities that the health care industry is trying to eradicate. As mentioned above, the NIH recently designated people with disabilities as a population that faces health disparities.
This distinction gives NIH the authority to allocate more funding to research into health disparities that affect individuals with disabilities, the forces behind those disparities, and solutions to promote equity.