Emory University, Georgia.
Emory University, Georgia.
Soc Sci Res. 2020 Mar;87:102395. doi: 10.1016/j.ssresearch.2019.102395. Epub 2019 Dec 20.
Researchers often explore health (care) beliefs as a function of individual characteristics; yet, few consider the role of context in shaping both beliefs and the behaviors that are informed by them. As a sociopolitical construct, ethnoraciality provides a concerning source of bias in studies of health (care) beliefs because it inhabits both individual and contextual forms. This study examines whether the ethnoracial context of the residential area where sexual minorities live is associated with a particular health (care) belief - sources of trustworthy health information - and considers how ethnoracial group membership status differentiates these ecological associations drawing on mediation and moderation models. Using data from the 2010 Social Justice Sexuality Project, our analysis shows that sexual minorities who live with high concentrations of Latinos and Whites are less likely to rely exclusively on medical professionals for trustworthy health information than those who live with high concentrations of Blacks. Moreover, exclusive reliance on medical professionals for health information among Black and Latino sexual minorities is stronger in co-ethnic communities (predominately Black and Latino areas, respectively). The analysis also documents status and contextual differentials and status-context contingencies of reliance on the Internet, social networks, and multiple agents ("triangulation") as sources of health information. Findings suggest that place-based co-ethnic networks may facilitate disease prevention among Black and Latino sexual minorities by improving the quality of their relationships with sick role gatekeepers and breaking down the silos of the medical complex. The study concludes by considering the value of a place-based approach to alleviating health disparities among sexual minorities vis-à-vis the health care system.
研究人员经常探讨健康（保健）信念作为个体特征的函数；然而，很少有人考虑到背景在塑造信念和受其影响的行为方面的作用。作为一种社会政治结构，民族种族身份在健康（保健）信念研究中是一个令人担忧的偏见来源，因为它既存在于个体层面，也存在于背景层面。本研究考察了性少数群体居住的居住区域的民族种族背景是否与特定的健康（保健）信念——可靠健康信息的来源——相关，并考虑了民族种族群体成员身份如何通过中介和调节模型来区分这些生态关联。本研究利用 2010 年社会公正性行为项目的数据，分析表明，与居住在黑人和白人高度集中地区的性少数群体相比，居住在拉丁裔和白人群体高度集中地区的性少数群体不太可能仅仅依靠医疗专业人员获取可靠的健康信息。此外，在种族群体内部社区（分别是黑人社区和拉丁裔社区）中，黑人和拉丁裔性少数群体对医疗专业人员的健康信息的依赖更为强烈。分析还记录了对互联网、社交网络和多个代理（“三角化”）作为健康信息来源的依赖的地位和背景差异以及地位-背景的偶然性。研究结果表明，基于位置的同种族网络可以通过改善他们与病角色守门人之间的关系质量和打破医疗复合体的隔阂，促进黑人和拉丁裔性少数群体的疾病预防。最后，研究通过考虑针对性少数群体的基于地点的方法相对于医疗保健系统来缓解健康差异的价值。
