5 facts about Black Americans and health care

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More Black Americans say health outcomes for Black people in the United States have improved over the past 20 years than say outcomes have worsened, according to a 2021 survey by the Pew Research Center. Most Black adults also say their most recent experiences with the health care system have been positive.

However, at the same time, Black Americans have broad structural concerns about health care in the US and experience disparities in outcomes. For example, death rates from cancer and maternal mortality rates are higher among Black Americans than among White Americans.

The Pew Research Center conducted this analysis to highlight the attitudes and experiences of Black Americans regarding health care. We surveyed 14,497 US adults from Nov. 30 through December 12, 2021, including 3,546 Black adults (including those who identify as single-race, multiracial and Black Hispanic).

The survey was conducted at the Centers American Trends Panel (ATP) and included an oversample of Black and Hispanic adults from the Ipsos KnowledgePanel. Respondents to both panels are drawn through national, random sampling of residences. This way almost every adult in the US has a choice. The survey was weighted to be representative of the US adult population by gender, race, ethnicity, partisan affiliation, education and other categories. Read more about the ATPs method.

Here are the survey questions used for this analysis, along with the responses, and its methodology.

This study was informed by a group of consultants with expertise related to the attitudes and experiences of Black and Hispanic Americans in science, health, STEM education and other areas. The Pew Research Center remains solely responsible for all aspects of the research, including any errors associated with its products and findings.

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

Black Americans’ recent experiences with the US health care system have been primarily positive. About six in ten Black adults (61%) say the care they received recently was either good (25%) or very good (36%), and another 25% say it was good. And about half (51%) say their out-of-pocket costs for that care are about what is fair.

A chart showing that a majority of Black adults give positive ratings to the quality of health care they have recently received.

However, these perceptions vary by income. About three-quarters of high-income Black adults (73%) describe their most recent care as good or very good, compared to 66% of middle-income and 55% of lower-income. And 67% of high-income Black adults say the out-of-pocket cost of their care is about fair, compared to 46% of lower-income Black adults.

However, a 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 ten say they 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 illness was not taken seriously ( 35%) or that their provider was rushing them (32%).

A bar chart showing that 40% of Black adults say they had to speak up to get proper medical care.

Black Americans’ answers to these questions were not significantly different from the answers of US adults in general. For example, 41% of all adults say they had to speak up to get proper care, and 32% say their illness is not serious.

Among Black Americans, younger women are the most likely to say they have had negative experiences with health care providers. For example, 52% of Black women ages 18 to 49 said they had to speak up to get proper care. That compares to 40% of Black women 50 and older, 36% of Black men 50 and older, and 29% of Black men 18 to 49.

A dot plot showing that younger Black women are more likely to say they have had negative health care experiences.

Overall, 71% of Black women ages 18 to 49 say they have had at least one negative interaction with a health care provider, compared to 54% of Black women 50 and older, 51% of Black men 50 and older, and 43% of Black men ages 18 to 49. (Women were asked about a total of seven experiences, including one related to women’s health, while men were asked about six experiences. Differences by age and gender remained when examining only the six experiences asked of both men and women.)

Younger Black women are also the most likely to say they prefer to see a Black provider and that a Black provider is better than other providers at looking out for their interests and giving them the highest quality care.

Black Americans cite a lack of access to high-quality medical care as the main reason why Black people generally have worse health outcomes than other people. More than six-in-ten Black adults (63%) say having less access to care is a major reason for these disparities, and another 22% say it’s a minor reason. Research has shown that there are likely to be fewer primary care doctors, trauma centers, pharmacies and COVID-19 vaccination centers near where Black Americans live.

A horizontally stacked bar chart showing that Black adults associate health disparities with less access to quality care, among other reasons.

About half or more of Black adults also point to several other factors as the main reasons that Black Americans tend to experience worse health outcomes. For example, 52% say the main reason is that Black people live in communities with more environmental problems, and 51% say a main reason is that Black people are more likely to have pre-existing health conditions.

Black adults with higher levels of education were more likely than those with lower levels of education to identify these and some other factors as the main reasons.

Most Black Americans say it makes no difference to them if they see a Black health care provider. More than six-in-ten (64%) say this. But 31% would prefer a Black provider, including 14% who would strong prefer it. Only 4% prefer no to see a Black provider.

There were no major differences in these perceptions depending on whether Black Americans had seen a Black health care provider in the past. The share of Black adults who prefer a Black health care provider is the same among those who have previously visited one (32%) and those who have never (30%).

However, Black providers are underrepresented in medicine, potentially making it harder for those who prefer a Black provider to find and book an appointment. Only 5% of physicians and surgeons nationwide are Black, and the same is true of physician assistants. Overall, Black Americans make up about 14% of the countries population.

Note: Here are the survey questions used for this analysisincluding responses, and its method.

Alec Tyson is an associate director of 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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