Department of Sociology and Anthropology, and Program in Health, Medicine, and Society, Lehigh University, Bethlehem, PA, USA.
Division of Health Policy and Management, University of Minnesota School of Public Health, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
J Racial Ethn Health Disparities. 2020 Aug;7(4):760-768. doi: 10.1007/s40615-020-00706-w. Epub 2020 Jan 27.
People bring the social contexts of their lives into the medical encounter. As a social determinant of health, police brutality influences physical and mental health. However, negative experiences with institutions such as law enforcement might decrease trust in other institutions, including medical institutions. Mistrust might limit engagement with the healthcare system and affect population health. This study investigates the relationship between police brutality and medical mistrust and assesses whether it varies by race.
Data were obtained from a 2018 cross-sectional survey of adults living in urban areas in the USA (N = 4389). Medical mistrust was regressed on police brutality (experiences and appraisal of negative encounters with the police), controlling for socio-demographics, health status, and healthcare access. Means of mistrust were predicted by racial group after including interactions between police brutality and race.
Respondents who had negative encounters with the police, even if they perceived these encounters to be necessary, had higher levels of medical mistrust compared to those with no negative police encounters. Police brutality increased mistrust for all racial groups.
Conditions outside the medical system such as experiencing police brutality impact relationships with the medical system. Given that clinicians are in a unique position of having access to firsthand information about the struggles and injustices that shape their patients' health, advocating for systemic change on behalf of their patients might build trust.
人们将生活中的社会背景带入医疗接触中。作为健康的社会决定因素之一，警察暴力行为会影响身心健康。然而，人们对执法机构等机构的负面体验可能会降低对其他机构的信任，包括医疗机构。不信任可能会限制人们与医疗保健系统的接触，并影响人口健康。本研究调查了警察暴力行为与医疗不信任之间的关系，并评估了这种关系是否因种族而异。
数据来自于 2018 年对美国城市地区成年人的横断面调查（N=4389）。控制社会人口统计学、健康状况和医疗保健获取情况后，将医疗不信任程度回归到警察暴力行为（经历和对与警察发生负面接触的评估）上。在包括警察暴力行为与种族之间的相互作用后，根据种族群体预测不信任的平均值。
与没有与警察发生过负面接触的受访者相比，即使认为这些接触是必要的，与警察发生过负面接触的受访者对医疗的不信任程度更高。警察暴力行为增加了所有种族群体的不信任。
医疗系统以外的情况，如经历警察暴力行为，会影响与医疗系统的关系。鉴于临床医生处于独特的位置，可以获得有关影响患者健康的斗争和不公正的第一手信息，代表患者倡导系统变革可能会建立信任。
