Racial/ethnic differences in physician distrust in the United States
Racial/ethnic differences in physician distrust in the United States
复制标题
DOI：
10.2105/ajph.2005.080762
复制
发表时间：
2007-07-01
影响因子：
12.7
通讯作者：
Putt, Mary
中科院分区：
文献类型：
--
作者：
Armstrong, Katrina;Ravenell, Karima L.;Putt, Mary
目标.我们研究了种族/民族和地理的变化，在美国的医生不信任。我们从社区跟踪研究中获得数据，分析了20个地点，其中至少5%的人口是西班牙裔，5%是黑人。在单变量分析中，黑人和西班牙裔报告了比白人更高的医生不信任水平。然而，多变量分析表明，社会人口学变量，居住城市，种族/民族，医生的不信任之间的复杂的相互作用。一般来说，较低的社会经济地位（定义为收入较低，教育程度较低，没有健康保险）与较高的不信任程度有关，男性通常比女性更不信任。但这些影响的强度受到种族/民族的影响。我们目前的例子，个别城市中，黑人报告一贯较高的平均水平的不信任比白人，一贯较低的平均水平的不信任比白人，或依赖于社会经济地位的混合关系。在同一个城市，西班牙裔报告要么一贯较高的平均水平的不信任相对于白人或混合关系。医生不信任的种族/民族差异不像以前假设的那样统一，存在大量的地理和个体差异。
Objectives. We examined the racial/ethnic and geographic variation in distrust of physicians in the United States.Methods. We obtained data from the Community Tracking Study, analyzing 20 sites where at least 5% of the population was Hispanic and 5% was Black.Results. In univariate analyses, Blacks and Hispanics reported higher levels of physician distrust than did Whites. Multivariate analyses, however, suggested a complex interaction among sociodemographic variables, city of residence, race/ethnicity, and distrust of physician. In general, lower socioeconomic status (defined as lower income, lower education, and no health insurance) was associated with higher levels of distrust, with men generally reporting more distrust than women. But the strength of these effects was modified by race/ethnicity. We present examples of individual cities in which Blacks reported consistently higher mean levels of distrust than did Whites, consistently lower mean levels of distrust than did Whites, or a mixed relationship dependent on socioeconomic status. In the same cities, Hispanics reported either consistently higher mean levels of distrust relative to Whites or a mixed relationship.Conclusions. Racial/ethnic differences in physician distrust are less uniform than previously hypothesized, with substantial geographic and individual variation present.