Doctor–patient relationships are a perceived barrier to chiropractic use by non-Hispanic Black Americans

Despite decades of targeted effort, the disparity in access to and utilization of health care remains high in minority populations. Not excluded is the field of chiropractic, where there is an ongoing effort to increase both non-Hispanic black (NHB) practitioners and patients in the United States. In this study, we sought to identify which barriers prevent NHB access to chiropractic care. We utilized Qualtrics© (Qualtrics, Provo, UT) and MTurk© (Amazon Mechanical Turk, Inc.) to administer an online survey to 3814 U.S. respondents. Among non-Hispanic blacks, and compared with whites, participants were more likely to consider chiropractic care if the doctor shares their racial identity (37.6% vs. 17.1%) or if referred by a family member or friend (83.1% vs. 72.2%). NHB respondents were more likely to report barriers such as communication, transportation, or not being understood by their care provider compared with their white counterparts. Interestingly, there were no significant differences between NHB and white respondents on cost-related barriers (e.g., too expensive, insurance does not cover chiropractic). These findings highlight a need for increasing the number of practicing NHB chiropractors, through improved minority recruitment to chiropractic colleges. Further, chiropractor-driven community outreach may also begin to address the disparities in access to care for the non-Hispanic black population.