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A model of weight‐based stigma in health care and utilization outcomes: Evidence from the learning health systems network
dc.contributor.authorPhelan, Sean M.
dc.contributor.authorBauer, Katherine W.
dc.contributor.authorBradley, David
dc.contributor.authorBradley, Steven M.
dc.contributor.authorHaller, Irina V.
dc.contributor.authorMundi, Manpreet S.
dc.contributor.authorFinney Rutten, Lila J.
dc.contributor.authorSchroeder, Darrell R.
dc.contributor.authorFischer, Kristin
dc.contributor.authorCroghan, Ivana
dc.date.accessioned2022-04-08T18:03:40Z
dc.date.available2023-05-08 14:03:38en
dc.date.available2022-04-08T18:03:40Z
dc.date.issued2022-04
dc.identifier.citationPhelan, Sean M.; Bauer, Katherine W.; Bradley, David; Bradley, Steven M.; Haller, Irina V.; Mundi, Manpreet S.; Finney Rutten, Lila J.; Schroeder, Darrell R.; Fischer, Kristin; Croghan, Ivana (2022). "A model of weight‐based stigma in health care and utilization outcomes: Evidence from the learning health systems network." Obesity Science & Practice 8(2): 139-146.
dc.identifier.issn2055-2238
dc.identifier.issn2055-2238
dc.identifier.urihttps://hdl.handle.net/2027.42/172006
dc.description.abstractObjectiveObesity is stigmatized and people with obesity report experiencing stigmatizing situations when seeking health care. The implications of these experiences are not well understood. This study tests an indirect effects model of negative care experiences as an intermediate variable between obesity and care avoidance/utilization and switching primary care doctors.MethodsA survey was completed by 2380 primary care patients in the Learning Health Systems Network (LHSNet) Clinical Data Research Network with a BMI >25 kg/m2. Measures included scales assessing stigmatizing situations, perceived patient‐centered communication, perceived respect, having delayed needed care, and having looked for a new primary doctor in the past 12 months. Sequential and serial indirect effects of care experiences and respect in the association between BMI and care utilization outcomes was modeled.ResultsThe hypothesized model was supported by findings. The associations between BMI and delaying needed care (OR = 1.06, p < 0.001) and attempting to switch primary doctors (OR = 1.02, p = 0.04) was mediated by both stigmatizing situations experienced in a health care context and lower patient‐centered communication. Lower perceived respect mediated the association between care experiences and utilization outcomes.ConclusionsPeople with higher BMIs may avoid care or switch doctors as a result of stigmatizing experiences and poor communication with doctors. These outcomes may contribute to morbidity in people with obesity if they delay or avoid care for health concerns when symptoms first present.
dc.publisherBlackwell
dc.publisherWiley Periodicals, Inc.
dc.subject.otherhealth care utilization
dc.subject.otherobesity
dc.subject.otherobesity bias
dc.subject.otherpatient‐centered care
dc.subject.othersocial stigma
dc.titleA model of weight‐based stigma in health care and utilization outcomes: Evidence from the learning health systems network
dc.typeArticle
dc.rights.robotsIndexNoFollow
dc.subject.hlbsecondlevelPublic Health
dc.subject.hlbtoplevelHealth Sciences
dc.description.peerreviewedPeer Reviewed
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/172006/1/osp4553.pdf
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/172006/2/osp4553_am.pdf
dc.identifier.doi10.1002/osp4.553
dc.identifier.sourceObesity Science & Practice
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dc.working.doiNOen
dc.owningcollnameInterdisciplinary and Peer-Reviewed


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