Forty-seven percent of health care workers nationwide have witnessed discrimination against patients in their facilities, and 52 percent say racism against patients is a crisis or major problem, according to a new report from The Commonwealth Fund and The African American Research Collaborative, or AARC.

Younger health care workers and health care workers of color were more likely than their older or white counterparts to say they witnessed discrimination.

The report, Revealing Disparities: Health Care Workers’ Observations of Discrimination Against Patients, is based on findings from a nationwide survey of more than 3,000 health care workers aimed at understanding the impact discrimination and racism have on health care professionals and patients.

“The study shines a light on the discrimination and racism health care workers observe and the implications for negative health outcomes of patients in many communities,” said Henry Fernandez, CEO of AARC and the report’s lead author. “Understanding this connection at a national level is critical to measuring and addressing discrimination in the health care system to mitigate harm to patients and produce better health outcomes overall.”

Other key report findings include:

• Patients are treated differently based on their race and ethnicity. More than half of health care workers (57%) witnessed discrimination against patients who predominantly speak a language other than English. About half (48%) stated that medical providers are more accepting when white patients self-advocate than when Black patients do so.
• Discrimination creates stress for health care workers. Just under half (47%) of all health care workers indicated that dealing with discrimination at work causes them stress.
• Health care workers at facilities with more patients of color are more likely to witness discrimination. Seventy percent of workers at facilities with predominantly Black patients and 61 percent of those working in facilities with mostly Latino patients witnessed discrimination compared with only 43 percent at facilities with mostly white patients.

While the report focuses on the impact of discrimination on patients, the full survey examined racism and discrimination in health care settings more broadly, including discrimination toward health care professionals, as well as employers’ role in addressing these issues.

Notable findings from the larger survey include:

• Workplace racism is prevalent in health care.
• Forty-four percent of all health care workers have observed coworkers subjected to racism in the workplace. When provided with examples of potential workplace discrimination, two-thirds indicate they have seen at least one of the examples.
• A majority of Black health care workers (58%) and more than four of 10 Latino (49%) and Asian American and Pacific Islander (AAPI, 44%) health care workers indicate they have been discriminated against in their workplaces because of their race or ethnicity.
• Health care workers fear retaliation. While majorities of health care workers see positive efforts from employers to address discrimination, a majority of Black, Latino, and AAPI health care workers worry about retaliation if they raise discrimination concerns.

When asked about potential solutions, more than two-thirds of health care workers thought the following steps could help:

• Providing an easy way to anonymously report situations involving racism or discrimination.
• Creating opportunities to listen to patients of color and health care professionals of color.
• Examining treatment of non-English-speaking patients.
• Training at professional schools or health care staff to spot discrimination.

“If we are going to build truly equitable health care systems, we have to start by listening to voices of those on the front lines,” said Dr. Laurie Zephyrin, M.D., Senior Vice President for Advancing Health Equity at The Commonwealth Fund and report co-author. “Understanding what health care workers are experiencing, and what they want and need from their employers and colleagues to address discrimination, is critical to successful and sustainable change.”

The full report can be found here.