5 facts about black Americans and health care

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According to a 2021 survey by the Pew Research Center, more black Americans say health outcomes for blacks in the United States have improved over the past 20 years than say outcomes have worsened. A majority of black adults also say their most recent experiences with the health care system have been positive.

At the same time, however, black Americans have broad structural concerns about health care in the United States and experience disparities in outcomes. For example, cancer and maternal mortality rates are higher among black Americans than among white Americans.

The Pew Research Center conducted this analysis to highlight black Americans’ attitudes and experiences with health care. We surveyed 14,497 US adults between November 30 and December 12, 2021, including 3,546 black adults (including those who identify as monoracial, multiracial, and black Hispanic).

The survey was conducted by the Centers American Trends Panel (ATP) and included an oversample of black and Hispanic adults from the Ipsos KnowledgePanel. Respondents for both panels are recruited using a national, random sample of residential addresses. That way, nearly all US adults have a choice. The survey is weighted to be representative of the US adult population by gender, race, ethnicity, political affiliation, education and other categories. Read more about theATPs methodology.

Here are the survey questions and answers and methods used in this analysis.

This study was informed by advisors with expertise in Black and Hispanic attitudes and experiences in science, health care, STEM education, and other fields. The Pew Research Center is solely responsible for all aspects of the study, including any errors in its products and results.

Here are five key facts about black Americans’ attitudes and experiences with health care, based on the 2021 Center’s survey:

Black Americans’ recent experiences with the US health care system are mostly positive. About six in 10 black adults (61%) say the most recent care they received was either excellent (25%) or very good (36%), and 25% say it was good. And about half (51%) say their out-of-pocket costs for this treatment were fair.

Chart showing that the majority of black adults give a positive rating of the quality of health care they most recently received.

However, views vary according to income. About three-quarters of high-income black adults (73%) describe their most recent care as excellent or very good, compared to 66% of middle-income adults and 55% of low-income adults. And 67 percent of high-income black adults say the out-of-pocket costs of their care were reasonable, compared to 46 percent of low-income black adults.

Still, the majority of black adults (55%) say they have had at least one negative interaction with doctors or other health care providers. For example, four in 10 say they have had to speak up to get proper care, making it the most common type of negative interaction we asked about in our 2021 survey. About a third say their pain is not taken seriously (35%) or that their caregiver has rushed them (32%).

Bar chart showing 40% of black adults say they had to speak up to get proper medical care.

Black American responses to these questions do not differ dramatically from those of US adults. For example, 41% of all adults say they have had to speak up to get proper care, and 32% say their pain has not been taken seriously.

Black American younger women are the most likely to say they have had negative experiences with health care providers. For example, 52% of black women between the ages of 18 and 49 say they have had to speak up to get proper care. That’s 40 percent of black women 50 and older, 36 percent of black men 50 and older, and 29 percent of black men 18-49.

Scatter plot showing that younger black women are more likely to say they have had negative experiences with health care.

Overall, 71 percent of black women ages 18 to 49 say they have had at least one negative interaction with a health care provider, compared to 54 percent of black women age 50 and older, 51 percent of black men age 50 and older, and 43 percent from blacks. men aged 18-49. (Women were asked about a total of seven experiences, one of which is related to women’s health, while men were asked about six experiences. Age and gender differences remain when only six experiences from both men and women are analyzed.)

Younger black women are also the most likely to say they would like to see a black provider and that a black provider is better than other providers at considering their interests and providing them with high-quality care.

Black Americans cite a lack of quality medical care as the main reason why black people’s health tends to be worse than that of other people. More than six in 10 black adults (63%) say poorer access to care is a major reason for these disparities, and 22% say it is a minor reason. Studies have shown that black Americans tend to have fewer primary care physicians, trauma centers, pharmacies and COVID-19 vaccination centers near where they live.

Horizontal stacked bar graph showing that black adults perceive health inequities as declining access to quality care and a variety of other reasons.

About half or more of black adults also cite several other factors as major reasons for the generally poorer health outcomes of black Americans. For example, 52% say the biggest reason is that blacks live in communities with more environmental problems, and 51% say the biggest reason is that blacks are more likely to have pre-existing health problems.

Black adults with high levels of education are more likely than people with less education to hold these and several other factors.

Most black Americans say it doesn’t matter to them if they see a black health care provider. More than six in ten (64%) say this. But 31% prefer a black provider, of which 14% would strongly I prefer this. Only 4% would like to No to see a black provider.

There are no major differences in these views based on whether black Americans have seen a black health care provider in the past. The percentage of black adults who prefer a black health care provider is similar among those who have (32%) and those who have not (30%).

However, black providers are underrepresented in medicine, which can make it difficult for those who want a black provider to find and make an appointment. Only 5% of physicians and surgeons nationwide are black, and the same is true for physician assistants. Overall, black Americans make up about 14 percent of the nations population.

Note: Here are Survey questions used in this analysisand the answers and its methodology.

Alec Tyson is the associate director for research at the Pew Research Center.

Mark Hugo Lopez is director of research on race and ethnicity at the Pew Research Center.

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