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Determinants of Trust in Health Care in an Older Population
Author(s) -
Guerrero Natalie,
Mendes de Leon Carlos F.,
Evans Denis A.,
Jacobs Elizabeth A.
Publication year - 2015
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.13316
Subject(s) - hostility , health care , medicine , socioeconomic status , race (biology) , gerontology , population , health equity , race and health , demography , public health , clinical psychology , environmental health , nursing , botany , sociology , economics , biology , economic growth
Objectives To explore differences in sociodemographic and psychological correlates of institutional trust in health care in an aging population of African Americans and non‐Hispanic whites. Design Cross‐sectional survey data from the longitudinal Chicago Health and Aging Project. Setting Population‐based study of three communities in the Chicago area. Participants African Americans (n = 2,284) and non‐Hispanic whites (1,354) with a mean age of 79.3. Measurements Demographic factors, socioeconomic status ( SES ), healthcare access, cynical hostility, perceived discrimination, depression, and institutional trust in health care. Results African Americans reported substantially lower healthcare trust than non‐Hispanic whites ( P < .001). After adjustment for demographic variables and SES , only race ( P < .001) and age ( P = .008) were significantly associated with healthcare trust scores. The association between race and healthcare trust was slightly attenuated after adjusting for cynical hostility, depressive symptoms, and perceived discrimination ( P < .001). Each of these variables was negatively associated with healthcare trust, and together these accounted for approximately 15% of racial differences in healthcare trust. Conclusion Psychological factors, not demographic characteristics, SES , or healthcare factors, appear to contribute the most to disparities in healthcare trust between older African Americans and non‐Hispanic whites.