Employees' Views of Discrimination in a Community Health Department

A social norms framework is used to conduct formative research on discrimination within the context of a community health department (CHD) to provide evidence of discrimination and lack of systematic managerial support in addressing instances of discrimination.

Abstract

Health inequalities suffered by many Americans are often enacted within health care delivery processes and can result in poor health outcomes, including premature death. The current study uses a social norms framework to conduct formative research on discrimination within the context of a community health department (CHD). An anonymous survey measured actual and perceived norms of employees (N = 95) as they relate to comfort with individuals of different racial/ethnic backgrounds, job expectations, and beliefs about health equalities as well as perceived barriers to health care. Employees also completed open-ended questions about individual and organizational responsiveness to perceived discrimination in the CHD. A clear pattern of results revealed misperceptions regarding what participants believed to be their coworkers' views on discrimination. Qualitative reports provide evidence of discrimination and lack of systematic managerial support in addressing instances of discrimination. Implications of these formative research results are discussed in terms of their utility for designing social norm messages that promote a climate for equitable health care delivery services.