Journal of the American Geriatrics Society · 2015
Determinants of trust in health care in an older population.
СтатьяПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
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Guerrero Natalie, Mendes de Leon Carlos F, Evans Denis A, Jacobs Elizabeth A
Аннотация
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.
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.