López-Cevallos Daniel F, Harvey S Marie, Warren Jocelyn T
Center for Latino/a Studies and Engagement, Oregon State University, Corvallis, Oregon.
J Rural Health. 2014 Fall;30(4):344-51. doi: 10.1111/jrh.12063. Epub 2014 Feb 27.
Little research has analyzed mistrust and discrimination influencing receipt of health care services among Latinos, particularly those living in rural areas. This study examined the associations between medical mistrust, perceived discrimination, and satisfaction with health care among young-adult rural Latinos.
This cross-sectional study analyzed data from 387 young-adult Latinos (ages 18-25) living in rural Oregon. The Behavioral Model of Vulnerable Populations was utilized as the theoretical framework. Correlations were run to assess bivariate associations among variables included in the study. Ordered logistic regression models evaluated the associations between medical mistrust, perceived discrimination, and satisfaction with health care.
On average, participants used health services 4 times in the past year. Almost half of the participants had health insurance (46%). The majority reported that they were moderately (32%) or very satisfied (41%) with health care services used in the previous year. In multivariable models, medical mistrust and perceived discrimination were significantly associated with satisfaction with health care.
Medical mistrust and perceived discrimination were significant contributors to lower satisfaction with health care among young-adult Latinos living in rural Oregon. Health care reform implementation, currently under way, provides a unique opportunity for developing evaluation systems and interventions toward monitoring and reducing rural Latino health care disparities.
很少有研究分析不信任和歧视对拉丁裔，尤其是农村地区拉丁裔获得医疗服务的影响。本研究调查了农村年轻拉丁裔成年人中医疗不信任、感知到的歧视与医疗满意度之间的关联。
这项横断面研究分析了来自俄勒冈州农村地区387名年轻拉丁裔成年人（年龄在18 - 25岁之间）的数据。弱势人群行为模型被用作理论框架。进行相关性分析以评估研究中纳入变量之间的双变量关联。有序逻辑回归模型评估医疗不信任、感知到的歧视与医疗满意度之间的关联。
参与者在过去一年中平均使用医疗服务4次。近一半的参与者有医疗保险（46%）。大多数人报告说他们对前一年使用的医疗服务中度满意（32%）或非常满意（41%）。在多变量模型中，医疗不信任和感知到的歧视与医疗满意度显著相关。
医疗不信任和感知到的歧视是俄勒冈州农村年轻拉丁裔成年人医疗满意度较低的重要因素。目前正在实施的医疗改革为开发评估系统和干预措施以监测和减少农村拉丁裔医疗差距提供了独特的机会。
