Schwei Rebecca J, Kadunc Kelley, Nguyen Anthony L, Jacobs Elizabeth A
Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, USA.
University of Wisconsin School of Medicine and Public Health, Madison, USA.
Patient Educ Couns. 2014 Sep;96(3):333-8. doi: 10.1016/j.pec.2014.06.003. Epub 2014 Jun 14.
Our objective was to explore whether there are differences in institutional trust across racial/ethnic groups and what factors might contribute to these differences.
We studied a convenience sample of 569 adults in Chicago grocery stores who self-identified as African American, Mexican-Hispanic, or white. We measured institutional trust and dichotomized responses into "high" and "low" trust. We used chi squared tests to examine differences in institutional trust across racial/ethnic groups and stepwise multivariable logistic regression to investigate how sociodemographic factors, health care access, health care usage, and previous negative experience with the health care system modified this relationship.
In unadjusted analysis, race/ethnicity was significantly associated with institutional trust (p<0.001). In the fully adjusted model, African Americans and Mexican-Hispanics had greater odds of reporting low trust compared to whites (OR: 1.90; 95%CI, 1.13-3.17; and OR: 2.34; 95%CI, 1.43-3.81, respectively); reporting a previous negative health care experience was the only other factor significantly related to having low trust (OR: 2.84; 95%CI, 1.83-4.41).
We found lower institutional trust in African Americans and Mexican-Hispanics and among participants reporting previous negative health care experiences.
Improving health care experiences, especially for racial/ethnic minority groups, could improve institutional trust and decrease health disparities in these populations.
我们的目的是探讨不同种族/族裔群体在机构信任方面是否存在差异,以及哪些因素可能导致这些差异。
我们对芝加哥杂货店中569名自我认定为非裔美国人、墨西哥裔西班牙人或白人的成年人进行了一项便利抽样研究。我们测量了机构信任,并将回答分为“高”信任和“低”信任。我们使用卡方检验来检查不同种族/族裔群体在机构信任方面的差异,并使用逐步多变量逻辑回归来研究社会人口因素、医疗保健可及性、医疗保健使用情况以及之前在医疗保健系统中的负面经历如何改变这种关系。
在未调整分析中,种族/族裔与机构信任显著相关(p<0.001)。在完全调整模型中,与白人相比,非裔美国人和墨西哥裔西班牙人报告低信任的几率更高(OR分别为:1.90;95%CI,1.13 - 3.17;以及OR:2.34;95%CI,1.43 - 3.81);报告之前有负面医疗保健经历是唯一与低信任显著相关的其他因素(OR:2.84;95%CI,1.83 - 4.41)。
我们发现非裔美国人和墨西哥裔西班牙人以及报告之前有负面医疗保健经历的参与者的机构信任较低。
改善医疗保健体验,尤其是针对种族/族裔少数群体,可能会提高机构信任并减少这些人群中的健康差距。