Experiences Of Discrimination And Health Status Among Black And Hispanic Adults With Heart Failure: The SCAN-MP Study

Abstract

Introduction

Heart failure (HF) disproportionately affects older Black and Hispanic adults. Studies indicate that Black and Hispanic adults report higher levels of physician distrust and experiences of discrimination compared to White adults. Despite knowing these differences, limited studies have examined the relationship between trust in physicians and experiences of perceived discrimination with health status among Black and Hispanic adults with HF.

Methods

We used data from the prospective Screening for Cardiac Amyloidosis with Nuclear Imaging in Minority Populations (SCAN-MP) study. Trust was measured using the Trust in Physician Scale, and experiences of discrimination were measured using the Everyday Discrimination Scale. Health status was examined using the Kansas City Cardiomyopathy Questionnaire (KCCQ). We ran linear regression models to examine the associations between trust in physician and experiences of perceived discrimination with health status. Models were adjusted for age, sex, race, ethnicity, education, and insurance status.

Results

The sample included 400 participants with a mean age of 72.5 (±8.94) years, of which 49.3% were female, 88.0% identified as Black and 29.0% identified as Hispanic, and 54.5% had New York Heart Association class II. The mean KCCQ overall summary score was 62.9 (±25.1), indicating moderate health status. After adjusting for covariates, higher scores on the Everyday Discrimination Scale (indicative of greater experiences of perceived discrimination) were associated with lower scores across several domains of KCCQ. Similarly, higher scores on the Everyday Discrimination Scale were associated with lower KCCQ summary scores for total symptoms, clinical summary, and overall summary, all of which indicate worse health status. Trust in physician was not significantly associated with overall health status.

Conclusions

Our findings indicate an association between experiences of perceived discrimination and worsened reported health status among and quality of life older Black and Hispanic adults with HF. These results underscore the importance of addressing discrimination to improve health outcomes among minority populations with HF.