Department of Anthropology, University of Missouri, Columbia, USA.
Department of Anthropology, University of California, Los Angeles, Los Angeles, USA.
Glob Public Health. 2024 Jan;19(1):2346207. doi: 10.1080/17441692.2024.2346207. Epub 2024 May 8.
Substantial evidence indicates that medical mistrust, resulting from experiences with discrimination and marginalisation, is a determinant of health disparities in minority populations. However, this research is largely limited to the US and other industrialised countries. To broaden our understanding of the role of medical mistrust on health-care decision making, we conducted a study on healthcare experiences and perceptions in a rural, underserved indigenous community in northwest Namibia ( = 86). Mixing semi-structured interview questions with the medical mistrust index (MMI), we aim to determine the relevance of the MMI in a non-industrialised population and compare index scores with reports of healthcare experiences. We find that medical mistrust is a salient concept in this community, mapping onto negative healthcare experiences and perceptions of discrimination. Reported healthcare experiences indicate that perceived incompetence, maltreatment and discrimination drive mistrust of medical personnel. However, reporting of recent healthcare experiences are generally positive. Our results indicate that the concept of medical mistrust can be usefully applied to communities in the Global South. These populations, like minority communities in the US, translate experiences of discrimination and marginalisation into medical mistrust. Understanding these processes can help address health disparities and aid in effective public health outreach in underserved populations.
大量证据表明，由于经历歧视和边缘化，医学不信任是少数族裔人群健康差距的决定因素。然而，这项研究在很大程度上仅限于美国和其他工业化国家。为了更广泛地了解医学不信任对医疗保健决策的影响，我们对纳米比亚西北部一个农村、服务不足的土著社区（=86）的医疗保健经验和看法进行了研究。我们将半结构化访谈问题与医学不信任指数（MMI）混合使用，旨在确定 MMI 在非工业化人群中的相关性，并将指数得分与医疗保健经验报告进行比较。我们发现，医学不信任在这个社区是一个突出的概念，与负面的医疗保健经验和歧视感知相关。报告的医疗保健经验表明，认为医务人员无能、虐待和歧视会导致对医务人员的不信任。然而，最近的医疗保健经验报告通常是积极的。我们的结果表明，医学不信任的概念可以有效地应用于全球南方的社区。这些社区和美国的少数族裔社区一样，将歧视和边缘化的经历转化为医学不信任。了解这些过程有助于解决健康差距问题，并有助于在服务不足的人群中进行有效的公共卫生宣传。
