Racial and gender disparities in patient-centered communication among older adults in the United States

Patient-centered communication is the foundation of patient-centered care (Iezzoni et al., 2012) and is strongly correlated with physical well-being and satisfaction with care (Fabbri et al., 2020; Schut, 2021). Prior studies on patient-centered communication lack consensus on how race and gender, two critical axes of social status and inequality, shape patient-centered communication (Palmer et al., 2014; Rogers et al., 2019; Shen et al., 2018; Trivedi et al., 2021). To analyze racial and gender disparities in patient-centered communication among older adults, I use data from the 2010 Health and Retirement Study and the 2011 Health Care Mail Survey to compare communication measures among racial groups and between men and women within each racial group. I examine patient-centered communication experiences of non-Hispanic Black/African American, non-Hispanic White, and Hispanic older men and women born in the United States using several models. The results demonstrate that there is an association between gender and race and patient-centered communication, with men having fewer experiences and Black respondents having more experiences of patient-centered communication after controlling for socioeconomic status, health, and healthcare access. To explain the racialized and gendered nature of medical communication, I integrate the theory of fundamental causes of health (Link and Phelan, 1995; Phelan and Link, 2015) with the relational theory of inequality (Tomaskovic-Devey, 2014).