Racial differences in trust in health care providers: The added role of perceived racial/ethnic discrimination
Abstract
Objective. To examine the added role of perceived racial/ethnic discrimination to the observed differences in trust of health care providers (HCPs) among Black Hispanic and White adults. Additional analyses were conducted to determine if specific covariates of interest were differentially associated with trust among some but not all of the racial/ethnic groups. Method . Secondary data analyses using the Kaiser Family Foundation’s Survey on American’s Perceptions of Racial Disparities in Health Care, a national random RDD sample of 3,884 adults. A binary coding scheme, high vs. low trust in HCPs, was utilized. Independent variables included perceived discrimination, patient/provider racial/ethnic concordance, self-rated health, health care utilization status and sociodemographic factors. Results . Consistent with other studies, results using multivariable logistic regression suggest that Blacks (OR 1.47; 95% CI, 1.13-1.87) and Hispanics (OR 1.37; 95% CI, 1.25-2.13) were more likely to report low levels of trust in HCPs than Whites. However, this relationship was completely attenuated after controlling for experience of unfair treatment due to race/ethnicity in the health care system and perception of unfair treatment due to race/ethnicity in the Health Care System (HCS) for Blacks (OR 1.22; 95% CI, .96-1.57) and Hispanics (OR 1.13; 95% CI .84-1.55). Results from the race-stratified analyses showed that both perceived interpersonal experiences and general perceptions of unfair treatment was associated with low trust. Blacks who perceived that unfair treatment occurs often in the health care system were 2.85 times more likely to report low trust than Blacks who do not perceive that unfair treatment occurs often in the health care system (P<.001). Among Hispanics, personally experiencing (self, family member or friend) unfair treatment in the health care system due to race/ethnicity was significantly associated with low trust (OR 1.59; 95% CI 1.06-2.39). White respondents who reported that unfair treatment occurs often due to race/ethnicity when seeking medical care were more likely to report low trust (OR 2.37, 95% CI 1.44-3.88) than Whites who did not report unfair treatment. Conclusions. The results are suggestive that low trust in HCPs is not specific to racial/ethnic minorities; instead is associated with personal experience/perception of unfair treatment in the HCS.
Degree
M.P.H.
Advisors
Hunte, Purdue University.
Subject Area
Public health|Health care management
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