MCLEAN, Va., & BEDFORD, Mass.–(BUSINESS WIRE)–A new MITRE-Harris Poll Survey on Patient Experience finds 52 percent of individuals in the United States feel their symptoms are “ignored, dismissed, or not believed” when seeking medical treatment. That number rises to 6-in-10 within the Hispanic community.

“And these categories are, of course, intersectional. There’s no question there is work to do to better serve all populations at the point-of-care.”

The polling also revealed that more than half of Blacks and Hispanics feel the “healthcare provider is biased against me based on their attitude, words, or actions,” contributing to a 4-in-10 average across all demographics. Fifty percent (50%) of respondents also reported “a healthcare provider assuming something about me without asking me.”

Additionally, the results indicate that several groups are all much more likely to experience bias, doubt, or language barriers when seeking treatment. These include individuals identifying as a person with a disability or having a chronic health condition, those responsible for managing access to healthcare for a family member or friend, and members of the LGBTQ+ community.

“These findings confirm unacceptable disparities in patient experience along racial and ethnic lines, for the LGBTQ+ community, and for those who are managing chronic health conditions or navigating the world with disabilities,” said Juliette Forstenzer Espinosa, senior Medicare, Medicaid, and Affordable Care Act Marketplace strategist, MITRE. “And these categories are, of course, intersectional. There’s no question there is work to do to better serve all populations at the point-of-care.”

Rob Jekielek, managing director, The Harris Poll, said, “With the evolution of online patient portals and digital support tools, we have seen stronger usage among those who need to navigate the system the most—individuals with a chronic illness or disability and those who manage the healthcare needs of others. However, this has not translated to substantially lower frustration with the healthcare system, including understanding of coverage and claims. Confusion and uncertainty are even higher among the majority of Americans who use the system sporadically, or only when specific needs arise.”

Additional key findings from the MITRE-Harris Poll Survey include:

• When consumers have a concern or question about a bill, they struggle with whom to call.
  Fifty-four percent (54%) of insured individuals in the United States say they don’t know whom to contact if they have an issue with a bill or claim. Individuals self-identifying as disabled or dealing with chronic illness, caregivers, Hispanics, and younger generations are more likely to say they do know whom to contact if they have issues.
• Prevalence of unexpected medical bills decreases slightly.
  Forty-three percent (43%) of insured Americans report receiving an unexpected bill because their insurance did not cover as much as expected – a decrease from a 2021 MITRE-Harris Poll Survey when 47 percent reported a billing surprise.
• Patients are overwhelmingly using portals.
  Nearly 9-in-10 insured individuals use online patient portals more often for test results (70%), appointments (64%), and medical records (63%) than for other applications, such as finding a healthcare provider (58%), reviewing insurance benefits (54%), managing prescriptions (54%), or filing a health insurance claim (37%). Insured Black, Indigenous, and people of color (BIPOC) groups are more likely than white individuals to use patient portals to find a healthcare provider or file a claim.
• Patients seeking some specialists may wait two months or more for a visit.
  While most Americans can schedule an imaging appointment or a visit with their primary care provider or general practitioner in less than two weeks, 1-in-5 say it can take two months or more to meet with specialized professionals such as mental health providers, specialty physicians, dentists, or optometrists.

Methodology

This survey was conducted online within the United States, September 27-29, 2022, among 2,047 adults (ages 18 and over) by The Harris Poll on behalf of MITRE via the Harris On Demand omnibus product.

Editor’s Notes:

• Survey findings and commentary slide presentation is available by request to media@mitre.org.
• Health Insurance Marketplace open enrollment runs from November 1, 2022 to January 15, 2023.

About The Harris Poll

The Harris Poll is one of the longest-running surveys in the U.S. tracking public opinion, motivations, and social sentiment since 1963, and is now part of Harris Insights & Analytics, a global consulting and market research firm that delivers social intelligence for transformational times. We work with clients in three primary areas: building twenty-first-century corporate reputation, crafting brand strategy and performance tracking, and earning organic media through public relations research. Our mission is to provide insights and guidance to help leaders make the best decisions possible. To learn more, please visit www.theharrispoll.com.

About MITRE

MITRE’s mission-driven teams are dedicated to solving problems for a safer world. Through our public-private partnerships and federally funded R&D centers, we work across government and in partnership with industry to tackle challenges to the safety, stability, and well-being of our nation. Learn more at mitre.org.

©2022 MITRE #22-4132 12-15-2022

Contacts

Media
Mike Murphy, external communications principal, MITRE media@mitre.org.

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And, to some degree, it seems, gender-affirming hormone therapy (specifically with testosterone). Two recent publications (here and here) agree that lipid profiles are adversely affected in transgender men taking testosterone, and by extension, calculated cardiovascular risk is also affected. As more evidence accumulates, risk relationships are coming into clearer focus. And risk, it seems, is real.

Gender-affirming care saves lives

But don’t let this deter you: gender-affirming healthcare saves lives. Suicide is a major risk for transgender people. This is on top of the risks associated with lack of access to routine care. Providing safe access to gender-affirming care, including hormone therapy if desired, is a powerful tool that reduces suicide and improves quality of life. And the medical community knows how to mitigate the risk of cardiovascular disease.

Embrace diversity

The transgender and gender-nonconforming population is diverse (and for that reason, I’ll use the term “gender diverse” from here). Some people might use pronouns you’re not familiar with. Some might identify as non-binary or another category you’re not familiar with. Some might be children. Some might be old. They can and do have every comorbidity you can think of, just like everyone else. Of course, this includes the number one killer of US adults: cardiovascular disease. And it’s not always entirely clear what the risk is, given the paucity of evidence about this population (there’s no gender identity data in the Framingham Heart Study, is there?).

Risk reduction in practice

Whether testosterone is prescribed or not, clinicians who care for gender diverse patients need to integrate risk reduction into gender-affirming care in meaningful and robust ways. The conversation cannot stop at “let’s measure lipid levels at baseline and check in every once in a while”. It cannot stop at “we offered tobacco cessation counseling”. It cannot stop at “we discussed the risks and benefits”. We can do more.

Start with access to high-quality care

This is a health equity issue. Medical providers, are you doing your part?

• The most important intervention to improve the health of gender diverse people is to facilitate access to safe, high-quality health care. This includes ensuring that every clinical environment is gender-inclusive and trauma-informed.
• Ensure your patients’ basic needs being met. It’s hard to talk about nutrition and stress reduction if you’re not sure where you’re going to sleep. Ask. And make necessary referrals. This is a powerful step.
• Consider the full spectrum of risk-reduction options — including but not limited to pharmacological approaches? Don’t under-manage risk. And let individual patients’ values and preferences inform treatment decisions. This is the standard of care — are you applying it?

Focus on prevention and wellness

• Focus on prevention. Provide support for lifestyle approaches to risk reduction that meet your gender-diverse patients where they are. Give strong recommendations. Facilitate access to nutrition support, exercise programs, smoking cessation, counseling, or whatever else your patient might need.
• Use the tools available to you — brief motivational interviewing can enable positive change, even in a busy visit.
• Find or develop lists of queer-friendly gyms, coaches, and running or hiking groups in your areas. Exercise is a powerful wellness tool physiologically, psychologically, and socially, but not all spaces and professionals are inclusive.

Use the data for good

We’ll continue to see more evidence about the health of gender-diverse people over the coming years. More research is underway, and research protocols are slowly becoming more nuanced and inclusive. As the evidence matures, we’ll likely see more risk factors emerge. We are responsible for taking this evidence into context and using it to reduce risk — not to create barriers to care.

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