Shared Ancestry or Ethnic Characteristics Discrimination

Fact Sheet: Protecting Patients and Recipients of Human Services from Discrimination Based on Actual or Perceived Shared Ancestry or Ethnic Characteristics

The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) enforces several civil rights laws that prohibit discrimination. These include, but are not limited to, Title VI of the Civil Rights Act of 1964 and its implementing regulations (Title VI)¹, which prohibits discrimination based on race, color, or national origin in any program or activity receiving Federal financial assistance from the Department, and Section 1557 of the Patient Protection and Affordable Care Act and its implementing regulations (Section 1557), which also prohibits discrimination on various bases, including, but not limited to, race, color, and national origin, in covered health programs and activities.² This bulletin describes how these laws may protect individuals who are or are perceived to be Jewish, Christian, Muslim, Sikh, Hindu, Buddhist, or of another religious group.

What Federal Laws Protect People from Unlawful Discrimination Based on Shared Ancestry or Ethnic Characteristics?

Title VI and Section 1557’s protection from race, color, or national origin discrimination extends to individuals who experience discrimination, including harassment, based on their actual or perceived: (i) shared ancestry or ethnic characteristics; or (ii) citizenship or residency in a country with a dominant religion or distinct religious identity.

Title VI and Section 1557 prohibit discrimination against individuals, including those who are or perceived to be Jewish, Christian, Muslim, Sikh, Hindu, or Buddhist, or of another religious group, if the discrimination is based on their ancestry or ethnic characteristics.

Examples of the kinds of incidents that could, depending upon the specific facts and circumstances, raise concerns under Title VI and Section 1557

A hospital denies staff or facility privileges to an Iraqi medical resident because she speaks with a foreign accent and wears a traditional headscarf.
An emergency room patient requests that a hospital change his attending physician because the patient associates the physician’s surname with Judaism and Israel, and the hospital honors the request.
A mental health clinic regularly provides inferior services, including longer wait times, to an individual perceived to come from a foreign country because of his religious attire.

Additional Protections

OCR also enforces other federal laws that prohibit religious discrimination in certain contexts, including:

Section 508 of the Social Security Act prohibits discrimination on the basis of age, race, color, national origin, disability, sex, or religion in the Maternal and Child Health Services Block Grant (42 USC § 708).
Section 533 of the Public Health Service Act prohibits discrimination on the basis of age, race, color, national origin, disability, sex, or religion in Projects for Assistance in Transition from Homelessness (42 USC § 290cc-33).
Section 1908 of the Public Health Service Act prohibits discrimination on the basis of age, race, color, national origin, disability, sex, or religion in programs, services, and activities funded by Preventive Health and Health Services Block Grants (42 USC §300w-7).
Section 1947 of the Public Health Service Act prohibits discrimination on the basis of age, race, color, national origin, disability, sex, or religion in programs, services, and activities funded by Community Mental Health Services Block Grant and Substance Abuse Prevention and Treatment Block Grants (42 USC § 300x-57).
The Family Violence Prevention and Services Act prohibits discrimination on the basis of race, color, national origin, disability, sex, or religion in programs, services, and activities funded under this Act (42 USC § 10406).
The Communications Act of 1934, as amended by Equal Employment Opportunity provisions, prohibits employment discrimination on the basis of age, race, color, religion, national origin, or sex by federally-funded public telecommunication entities (47 USC § 398).
Patient Visitation Rights prohibit religious discrimination in patient visitation at hospitals and long-term care facilities funded by Medicare and Medicaid (42 C.F.R. § 482.13(h), 42 C.F.R. § 483.10(f)(4)(vi)(C)).

Examples of incidents that may, depending on the specific facts and circumstances, raise concerns under these authorities:

An HHS-funded non-profit health clinic denies primary care services to any patient who identifies as a Jehovah’s Witness.
A nursing home permits staff to destroy patient property that depicts certain religious images.
Hospital staff significantly delays treating a patient because the patient is wearing a necklace with a religious emblem.
A long-term care facility subjects residents of a certain religion to greater restrictions on religious/pastoral visitation than it imposes on residents of a different faith.

What can a person do if an individual experiences discrimination based on shared ancestry or ethnic characteristics?

Anyone who believes they have been discriminated against based on race, color, or national origin can file a complaint of discrimination with OCR. To file a complaint, visit: https://www.hhs.gov/civil-rights/filing-a-complaint/index.html.

Additional Resources

To learn more about non‐discrimination on the basis of race, color, national origin, sex, age, and disability; conscience and religious freedom; and health information privacy laws, please visit: https://www.hhs.gov/ocr/index.html.

Please note this resource does not have the force and effect of law. HHS’s enforcement of Title VI, 1557, and other laws cited in this bulletin stems from those laws and their implementing regulations.

The Fact Sheet is available in the following languages: