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Chanita Hughes Halbert, PhD; Katrina Armstrong, MD; Oscar H. Gandy, Jr, PhD; Lee Shaker, BA

Arch Intern Med. 2006;166:896-901.

Background  Although trust in health care providers (physicians, nurses, and others) may be lower among African Americans compared with whites, limited information is available on factors that are associated with low trust in these populations. This study evaluated the association between trust in health care providers and prior health care experiences, structural characteristics of health care, and sociodemographic factors among African Americans and whites.

Methods  National survey of 954 non-Hispanic adult African Americans (n = 432) and whites (n = 522).

Results  African Americans (44.7%) were more likely than whites (33.5%) to report low levels of trust in health care providers (² = 12.40, P<.001). Fewer quality interactions with health care providers had a significant effect on low trust among African Americans (odds ratio [OR], 3.23; 95% confidence interval [CI], 1.97-5.29; P<.001) and whites (OR, 3.99; 95% CI, 2.44-6.50; P<.001). Among African Americans, respondents whose usual source of care was not a physician's office were most likely to report low trust (OR, 1.73; 95% CI, 1.15-2.61; P = .02), whereas among whites, women (OR, 1.54; 95% CI, 1.04-2.30; P = .03) and respondents with fewer annual health care visits (OR, 1.52; 95% CI, 1.02-2.28; P = .04) were most likely to report low trust.

Conclusions  Compared with whites, African Americans were most likely to report low trust in health care providers. While fewer quality interactions with health care providers were associated significantly with low trust in both populations, usual source of medical care was only associated with low trust among African Americans, whereas sex and the number of annual health care visits were associated with low trust among whites. Different factors may influence trust in health care providers among African Americans and whites.

Author Affiliations: Departments of Psychiatry (Dr Halbert) and Medicine (Dr Armstrong), Abramson Cancer Center, Philadelphia, Pa; and Leonard Davis Institute of Health Economics (Drs Halbert and Armstrong) and Annenberg School for Communication (Dr Gandy and Mr Shaker), University of Pennsylvania, Philadelphia.

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