Attitudes About Racism, Medical Mistrust, and Satisfaction With Care Among African-American and White Cardiac Patients

Johns Hopkins University, School of Hygiene and Public Health, Department of Health Policy and Management, Baltimore, MD 21205, USA.
Medical Care Research and Review (Impact Factor: 2.62). 02/2000; 57 Suppl 1(4):146-61. DOI: 10.1177/1077558700574007
Source: PubMed


The authors examine determinants of satisfaction with medical care among 1,784 (781 African American and 1,003 white) cardiac patients. Patient satisfaction was modeled as a function of predisposing factors (gender, age, medical mistrust, and perception of racism) and enabling factors (medical insurance). African Americans reported less satisfaction with care. Although both black and white patients tended not to endorse the existence of racism in the medical care system, African American patients were more likely to perceive racism. African American patients were significantly more likely to report mistrust. Multivariate analysis found that the perception of racism and mistrust of the medical care system led to less satisfaction with care. When perceived racism and medical mistrust were controlled, race was no longer a significant predictor of satisfaction.

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    • "The study attends to one dimension of religion that has been found to be associated with how an individual views and responds to racial discrimination (Lincoln & Mamiya, 1990) À religious affiliation. Discrimination in the medical encounter and, specifically, the patientphysician relationship may be a culprit for a lack of trust among blacks (LaVeist et al., 2000; Smedley, Stith, & Nelson, 2003). For instance, although only 14 percent of blacks indicate that they personally have been treated unfairly in medical encounters due to their race or ethnicity, 35 percent indicate that either a family member or someone they know has been treated unfairly (Lillie-Blanton, Brodie, Rowland, Altman, & McIntosh, 2000). "
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    ABSTRACT: Purpose: Past research indicates that blacks are less trusting of physicians than are whites; yet, researchers have not examined within group differences in physician trust by religious denomination – an effort that is complicated by the high correlated nature of race and religion. To better understand black-white differences in physician trust, this paper examines heterogeneity in trust levels among blacks associated with religious designations that distinguish Black Protestants from other ethnoreligious groups. Methodology/Approach: Using data from the 2002 and 2006 General Social Surveys, this study adopts an intersectional (i.e., race X religion) typology of religious denomination to understand the black-white gap in physician trust. Weighted multivariate linear regression is employed. Findings: Black-white differences in physician trust are identified only when religious affiliation is considered but not when religious affiliation is omitted. Blacks who are affiliated with Black Protestant churches are more trusting than other religious groups, including Evangelical Protestants, Mainline Protestants, and blacks who are affiliated with other faiths. Originality/Value of Paper: This paper indicates that there is more heterogeneity in trust levels among blacks than between blacks and whites. Moreover, the findings suggest that religion can play an important role in bridging the trust gap between blacks and the medical sciences.
    Full-text · Chapter · Sep 2015
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    • "Second, Blacks and Latinos are more likely than Whites to report they feel disrespected by their health care providers (Blanchard and Lurie, 2004). Third, studies indicate that Blacks and Latinos are less satisfied with the quality of the care they receive from doctors (Doescher et al., 2000; LaVeist et al., 2000; Saha et al., 1999). Fourth, studies show that minorities receive less quality communication than Whites: Physicians are more likely to dominate conversations, less likely to speak of socioemotional topics, and less likely to exchange positive affective tones with minority patients than with White patients (Johnson et al., 2004; see also Cooper-Patrick et al., 1999; Julliard et al., 2008; Morales et al., 1999). "
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    ABSTRACT: Past research yields mixed evidence regarding whether ethnoracial minorities trust physicians less than Whites. Using the 2002 and 2006 General Social Surveys, variegated ethnoracial differences in trust in physicians are identified by disaggregating a multidi-mensional physician trust scale. Compared to Whites, Blacks are less likely to trust the technical judgment and interpersonal competence of doctors. Latinos are less likely than Whites to trust the fiduciary ethic, technical judgment, and interpersonal competence of doctors. Black–Latino differences in physician trust are a function of ethnoracial differences in parental nativity. The ways ethnoracial hierarchies are inscribed into power-imbalanced clinical exchanges are discussed.
    Full-text · Article · Jul 2015 · Social Science Research
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    • "The patient needs to believe that the medical institution will protect him/her and will ensure a safe environment for healthcare services (Gilson, 2003), because they are the basis of patient's decision to access the services of a certain type of medical institution. The literature on institutional trust pinpoints that a State with low level of institutional trust is associated with a frequent change of physicians, with requests for a second opinion (Zheng et al., 2002; Balkrishnan et al., 2003), with weak trust in the physician's skills and a drop in the patient's level of satisfaction (LaVeist, Nickerson, Bowie, 2000). A high level of institutional trust is associated with improved physical and mental health, decrease in the number of emergencies, increase in the degree of acceptance and use of vaccines (Whetten et al., 2006; Altice, Mostashari, Friedland, 2001), and increase in the number of persons who agree to be donors (Boulware et al., 2003). "

    Full-text · Article · Dec 2014
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