(PS2-5) Does Medical Discrimination Influence Health Motivation and Readiness Behavior among College Students?

Abstract Text: While extensive research has documented the detrimental effects of everyday discrimination on mental health outcomes, far less is known about how medical discrimination (bias and inequitable treatment within healthcare settings) impacts college students. This gap is particularly concerning given that college students are among the least likely age group to utilize healthcare services, and are simultaneously tasked with developing independence in managing their health, an important developmental goal for emerging adults. This study examines (1) the relationship between ethnic identity and experiences of medical discrimination and (2) whether medical discrimination and mental health symptoms predict health motivation and health independence readiness (the ability to seek, manage, and adhere to treatment, including mental health care). A total of 2532 undergraduate students (Mage=21.4±5.88, 66.9% female), racially and ethnically diverse (26.6% Asian, 15.6% Black, 28.8% Latinx, 12.4% White, 4.4% Middle Eastern, 12.2% Other or combination) were recruited from seven public colleges in New York City. The online survey assessed medical discrimination (Discrimination in Medical Settings) based on various races/ethnicities and the measured outcomes included health motivation (Health Engagement Control Strategies), readiness for health independence (Readiness Transition to Adult Healthcare), and mental health symptoms (Depression, Anxiety, and Stress Scale). A total of 50% of participants reported experiencing medical discrimination some of the time on at least one item. One-way ANOVA analyses revealed a significant effect for perceived medical discrimination by ethnic identity, F(5, 2517)=5.72, p< .001. Post hoc Tukey tests indicated that Black individuals reported significantly greater medical discrimination than both Latinx individuals (p <.001) and White individuals (p=.011). Using a Pearson correlation, medical discrimination was associated with more mental health symptoms (r=.334), less health management (r=-.119), and decreased readiness for health independence (r=-.070). Additionally, increased motivation for health management was significantly associated with higher readiness for health independence (r=.47) (all p<.001). A multiple linear regression model showed that mental health symptoms but not medical discrimination predicted decreased health motivation and readiness, p<.001. These findings highlight that Black individuals experience significantly greater medical discrimination than Latinx and White individuals. Medical discrimination was linked to increased mental health symptoms, lower motivation for health management, and decreased readiness for health independence, though having mental health symptoms was the strongest predictor of reduced health motivation and readiness. This suggests that the mental health consequences of discrimination may indirectly hinder healthcare engagement among college students. Implementing identity-affirmative, culturally responsive interventions that address medical discrimination and mental health symptoms could improve motivation and independence readiness in diverse student populations.