Factors Affecting Health-Care Allocation Decisions: A Case of Aversive Racism?


Correspondence concerning this article should be addressed to Virginia A. Murphy-Berman, Department of Psychology, University of Nebraska-Lincoln, 209 Burnett Hall, Lincoln, NE 65588-0308.


A distributive justice framework is used to examine how individuals make judgments about what is fair when making different types of health-care allocation decisions. The effects of 4 patient characteristics are assessed: (a) prognosis, (b) degree of responsibility for illness, (c) employment status, and (d) race. Results reveal that when the patient was defined as being more versus less responsible for his illness, respondents gave him a significantly lower priority score for obtaining health-care services, and they felt that he should be more responsible for paying for or soliciting funds to cover the costs of his health needs. Respondents also reacted with more negative emotion to the responsible patient and described him in more negative trait terms. Although patient's race produced no main effects, race did interact with employment status on several key variables. When the patient was described as being unemployed, the White patient compared to the Black patient was given a higher health-care priority score, he was resented less, and respondents were more willing to contribute money to pay for his health-care costs; but when the patient was described as being employed, the direction of differences between the races on these variables was reversed.