Abstract Body: Introduction
Experiencing discrimination in healthcare settings negatively impacts health care utilization and outcomes, contributing to health disparities. Discrimination is a psychosocial stressor, and when experienced in healthcare is linked with distrust of healthcare providers, fewer preventive screenings, and poorer physical well-being. These effects are particularly concerning for individuals with hypertension who require regular treatment from medical professionals. The objective of this study is to examine healthcare utilization among Black adults with hypertension who have experienced racial discrimination in healthcare settings.

Hypothesis
We hypothesize that Black adults with hypertension, individuals that have experienced racial discrimination in the healthcare setting may be less likely to utilize the healthcare system.

Methods
We conducted a cross-sectional analysis using 2020 California Health Interview Survey data. Participants were Black adults aged 18 or older with self-reported hypertension. To assess healthcare utilization we utilized survey items, including delays in seeking medical care, visits to the emergency room, and delays in prescriptions. Data was analyzed using descriptive statistics, chi-square tests, and ordinal logistic regression using STATA Version 18.

Results
The study sample included 532 participants with an average age of 55 and the majority identified as women (62.4%). Eleven percent of participants reported experiencing discrimination in the healthcare setting. Approximately 15.7% of participants reported delays in seeking medical care in the past 12 months and 12.4% reported delays in refilling prescriptions. The adjusted analysis did not reveal a statistically significant relationship between discrimination in the healthcare setting and prescriptions delays (OR 1.11, p = 0.782) or having a usual source of health care (OR 0.79, p = 0.683). The findings revealed that participants reporting no delays in seeking medical care within the past 12 months (OR 3.19, p = <0.001) were less likely to experience discrimination in the healthcare setting.

Conclusion
Within this sample of Black adults with hypertension, discrimination was associated with utilization of the ER and delays in medical care. In conclusion, the study findings underscore the persistent effects of racial discrimination and highlights a need for addressing discrimination in healthcare settings to create meaningful improvements in quality of care for Black patients.