Perception of racism explains the difference between Blacks' and Whites' level of healthcare trust.

Abstract

To test the hypothesis that the level of healthcare trust does not differ between Blacks and Whites. Cross-sectional telephone-based survey. This study recruited low-income residents of Miami-Dade and Duval counties in Florida by using random-digit dialing (RDD). One thousand and five residents participated; however, analyses were limited to Black (n=550) or White (n=374) respondents. Trained interviewers used a structured questionnaire to obtain information about respondent demographics, trust in health care, perception of racism, and access to care. Black respondents included fewer males (P=.0146) and younger subjects (P < or = .05); otherwise, they were similar to White respondents. Compared to Duval County respondents, Miami-Dade respondents were younger (< or = .05), richer (< or = .05), and mostly males (P=.0355). Blacks perceived more racism than did Whites (P<.0001). Healthcare trust differed by race and respondents' county (P<.0001). The proportion of variance in healthcare trust explained (R2) by race was 2%. Introducing perception of racism into the model eliminated differences in trust between White and Black respondents. Overall, the model explaining healthcare trust accounted for 21.2% of the variance in trust; the model adjusted for respondents' county, demographics, access to care, and liking treatment during routine appointment. This study observed that perception of racism accounted for the residual differences in healthcare trust between Whites and Blacks; therefore, healthcare distrust may not be an attribute of Blacks. Respondents' experience with the healthcare system accounted for most of the difference in trust.