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Gender Identity, Race, and Ethnicity-based Discrimination in Access to Mental Health Care: Evidence from an Audit Correspondence Field Experiment

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  • Luca Fumarco
  • Benjamin Harrell
  • Patrick Button
  • David Schwegman
  • E Dils

Abstract

Racial, ethnic, and gender minorities face mental health disparities. While mental health care can help, minoritized groups could face discriminatory barriers in accessing it. Discrimination may be particularly pronounced in mental health care because providers have more discretion over accepting patients. Research documents discrimination broadly, including in access to health care, but there is limited empirical research on discrimination in access to mental health care. We provide the first experimental evidence, from a correspondence audit field experiment (“simulated patients” study), of the extent to which transgender and non-binary people, African Americans, and Hispanics face discrimination in access to mental health care appointments. We find significant discrimination against transgender or non-binary African Americans and Hispanics. We do not find evidence of discrimination against White transgender and non-binary prospective patients. We are mostly inconclusive as to if cisgender African Americans or Hispanics face discrimination, except we find evidence of discrimination against cisgender African American women.

Suggested Citation

  • Luca Fumarco & Benjamin Harrell & Patrick Button & David Schwegman & E Dils, 2020. "Gender Identity, Race, and Ethnicity-based Discrimination in Access to Mental Health Care: Evidence from an Audit Correspondence Field Experiment," NBER Working Papers 28164, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:28164
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    Cited by:

    1. Button, Patrick & Walker, Brigham, 2020. "Employment discrimination against Indigenous Peoples in the United States: Evidence from a field experiment," Labour Economics, Elsevier, vol. 65(C).
    2. Moody, Myles D. & Browning, Wesley R. & Hossain, Monir & Clay, Olivio J., 2023. "Vicarious experiences of major discrimination, anxiety symptoms, and mental health care utilization among Black Adults," Social Science & Medicine, Elsevier, vol. 316(C).
    3. Sylvain Chareyron & Yannick L’Horty & Pascale Petit, 2023. "Cream skimming and discrimination in access to medical care: A field experiment," Health Economics, John Wiley & Sons, Ltd., vol. 32(8), pages 1868-1883, August.
    4. Luca Fumarco & S. Michael Gaddis & Iain Snoddy, 2021. "Winmail3: An automated email package with an application to correspondence audit tests," Working Papers 2110, Tulane University, Department of Economics.
    5. Catherine Balfe & Patrick Button & Mary Penn & David Schwegman, 2021. "Infrequent Identity Signals and Detection Risks in Audit Correspondence Studies," NBER Working Papers 28718, National Bureau of Economic Research, Inc.
    6. Tom Lane, 2023. "The strategic use of social identity," Discussion Papers 2023-01, The Centre for Decision Research and Experimental Economics, School of Economics, University of Nottingham.

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    More about this item

    JEL classification:

    • C93 - Mathematical and Quantitative Methods - - Design of Experiments - - - Field Experiments
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J15 - Labor and Demographic Economics - - Demographic Economics - - - Economics of Minorities, Races, Indigenous Peoples, and Immigrants; Non-labor Discrimination
    • J16 - Labor and Demographic Economics - - Demographic Economics - - - Economics of Gender; Non-labor Discrimination

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