Perceptions and experiences regarding the impact of race on the quality of healthcare in Southeast Brazil: a qualitative study

ABSTRACT

Objective: To explore the impact of race on the quality of healthcare received by patients attending a primary care centre in Brazil.

Design: This was a qualitative study consisting of 19 semi-structured interviews conducted on patients from six racial groups (as defined in Brazil as white, yellow, brown, black and indigenous and one self-identified ‘other’ group). The interviews were analysed using thematic analysis.

Results: Four main themes were identified during analysis; factors affecting the access to healthcare, experiences regarding quality of healthcare, discrimination in healthcare and deep-rooted societal discrimination, which were categorised into a number of sub-themes. Within these themes, interviewees reported (1) experiences of racism in society towards the black racial group, (2) one personal perception and two observations of racial discrimination in healthcare, (3) perceived racial discrimination due to healthcare professional behaviour and (4) other factors, such as delays in appointments and long waiting times in health facilities were felt to impact access to care.

Conclusion: The findings suggest that racial discrimination exists in Brazilian society but its direct impact on healthcare access was felt to be less obvious. Instead, organisational level factors were felt to contribute to difficulty accessing care. Interviewees perceived that racial discrimination may affect the quality of care, particularly for those designated as ‘black’. Socio-economic factors were felt to influence discrimination in healthcare. The findings can help inform further studies and educational initiatives to help address discrimination and access to healthcare in Brazil.

KEYWORDS:

• Racial discrimination
• race
• accessibility
• healthcare
• Brazil

Acknowledgements

I wish to thank the staff and participants at the Health centre for their support and participation. I would like to acknowledge the University of Birmingham for providing the opportunity to carry out this research and for their continuing support. I wish to ackowledge and thank the Yorke Williams Bequest for their support. I would also like to thank the translator for the transcription and translation of the transcripts.

Disclosure statement

No potential conflict of interest was reported by the authors.

Key messages

• There have been conflicting results from previous studies investigating the impact of race on access to healthcare.

• This study revealed that some participants perceived that racial discrimination impacts healthcare access or quality particularly directed towards the black racial group. Further research is needed to substantiate these findings.

• The participants perceived race to be a discriminatory factor in other aspects of society.

• Other factors, such as, delays in the health system and socioeconomic status were felt to impact access to healthcare in Brazil.

• This study can help to inform further research studies in this area.

Additional information

Funding

This study was supported by the University of Birmingham.