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Prevalence of medical mistrust and perceptions of racism among women in the deep south

Amal J Khoury, PhD, MPH1, Nedra Lisovicz, MPH, CHES2, and Amanda Avis, MPH1. (1) Center for Community Health, University of Southern Mississippi, Box 5122, Hattiesburg, MS 39406, 601-266-5435, Amal.Khoury@usm.edu, (2) Center for Sustainable Health Outreach, University of Southern Mississippi, Box 10015, Hattiesburg, MS 39406

Research Objective: People’s trust of the healthcare system affects their use of services and therefore their health outcomes. There is concern that residents of the deep south underutilize services because of medical mistrust. This study examined the prevalence of medical mistrust and perceptions of racism among Mississippi women. We focus on women because they make the majority of healthcare decisions for their family. Design: A statewide cross-sectional survey of women 40 years of age and older was conducted in Mississippi in 2003. Computer-assisted telephone interviewing was used. A questionnaire was developed, pilot tested, and finalized. Face validity and content validity of the questionnaire were established. Findings: A representative sample of 1,050 women was surveyed. One out of 3 women belonged to a minority group. Almost half of the women had no college education, and 40% reported an annual household income of less than $20,000. One half were privately insured; the other half had public insurance or no insurance. Three survey items assessed women’s trust of the healthcare system. Approximately 2 of 3 women agreed that rich people received better medical care than poor people, and 3 of 4 women agreed that health insurance affected the kind of care that a person received. Almost half of the respondents indicated that hospitals sometimes did not tell patients the truth. Three other items assessed perceptions of racism. A majority of women believed that doctors took the medical complaints of people of their race seriously. However, 31% reported that doctors hid information from patients of their race, and 42% believed that hospitals did not provide the same kind of care to people of different races. Analysis of the prevalence of mistrust among sociodemographic groups of women, as well as the association between mistrust and perceived quality of care, is underway. Conclusions/Implications: Prevalence of medical mistrust and perceptions of racism among women in the deep south, and especially among disadvantaged groups, is relatively high. Research is needed to understand the underlying reasons, as well as the impact of mistrust on healthcare use. Interventions are needed to promote medical trust. Such interventions should complement the efforts to eliminate healthcare disparities.

Learning Objectives:

Keywords: Women's Health,

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Studies about Health Care Service Utilization by Women (Womens' Health Contributed Papers #2)

The 132nd Annual Meeting (November 6-10, 2004) of APHA