Armstrong Katrina, Ravenell Karima L, McMurphy Suzanne, Putt Mary
Department of Medicine and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA 19104, USA.
Am J Public Health. 2007 Jul;97(7):1283-9. doi: 10.2105/AJPH.2005.080762. Epub 2007 May 30.
We examined the racial/ethnic and geographic variation in distrust of physicians in the United States.
We obtained data from the Community Tracking Study, analyzing 20 sites where at least 5% of the population was Hispanic and 5% was Black.
In univariate analyses, Blacks and Hispanics reported higher levels of physician distrust than did Whites. Multivariate analyses, however, suggested a complex interaction among sociodemographic variables, city of residence, race/ethnicity, and distrust of physician. In general, lower socioeconomic status (defined as lower income, lower education, and no health insurance) was associated with higher levels of distrust, with men generally reporting more distrust than women. But the strength of these effects was modified by race/ethnicity. We present examples of individual cities in which Blacks reported consistently higher mean levels of distrust than did Whites, consistently lower mean levels of distrust than did Whites, or a mixed relationship dependent on socioeconomic status. In the same cities, Hispanics reported either consistently higher mean levels of distrust relative to Whites or a mixed relationship.
Racial/ethnic differences in physician distrust are less uniform than previously hypothesized, with substantial geographic and individual variation present.
我们研究了美国不同种族/族裔群体以及不同地理位置人群对医生不信任程度的差异。
我们从社区追踪研究中获取数据，分析了20个地区，这些地区至少5%的人口为西班牙裔，5%的人口为黑人。
在单变量分析中，黑人和西班牙裔人群报告的对医生的不信任程度高于白人。然而，多变量分析表明，社会人口统计学变量、居住城市、种族/族裔以及对医生的不信任之间存在复杂的相互作用。一般来说，社会经济地位较低（定义为低收入、低教育水平且无医疗保险）与更高程度的不信任相关，男性通常比女性报告更多的不信任。但这些影响的强度因种族/族裔而有所不同。我们列举了一些城市的例子，在这些城市中，黑人报告的不信任平均水平始终高于白人，始终低于白人，或者存在一种取决于社会经济地位的混合关系。在同一城市中，西班牙裔人群报告的相对于白人的不信任平均水平要么始终较高，要么存在混合关系。
不同种族/族裔群体在对医生的不信任方面的差异并不像之前假设的那样统一，存在显著的地理和个体差异。
