Explanations for race-based disparities in health and health care abound, yet the mechanisms through which individuals reach determinations of discrimination remains poorly understood. This study collected and analyzed first-person narratives from 12 African American adults regarding their interactions with the health care system to elucidate possible sources of racism and discrimination while seeking medical care. Our analysis revealed that participants reached conclusions of perceived discrimination and differential treatment through their comparative observations and intuitive judgments. In such instances, they found it necessary to develop strategies to overcome the perceived lack of attention they received. Additionally, many participants expressed a considerable difference in the quality of interpersonal interactions between themselves and some of their health care providers, compared to interactions their providers had with patients from groups that are not racially underrepresented. In such instances, participants were compelled to develop strategies to overcome what they perceived to be a lack of attention.
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