title: Will public health's response to terrorism be fair? Racial/ethnic variations in perceived fairness during a bioterrorist event.
abstract: OBJECTIVE
  Public health departments' effectiveness during catastrophic bioterrorism will require trust on the part of diverse communities. This study describes variations in perceptions that the public health system will respond fairly to one's needs in a bioterrorist event, regardless of race/ethnicity, income, or other characteristics.
  
  
  METHODS
  Using the Los Angeles County Health Survey, a random-digit, population-based, telephone survey, we conducted multivariate logistic regression of race/ethnicity on perceived fairness, adjusting for demographic factors and perceived neighborhood safety. We performed similar analyses stratified by race/ethnicity subgroup.
  
  
  RESULTS
  Overall, 72.7% of respondents perceived that the public health system will respond fairly in a bioterrorist event. African Americans (AA) and Asian/Pacific Islanders (API) reported the lowest perceived fairness (AA 63.0%, API 68.2%, Latino 73.1%, White 76.6%, p = 0.005 for group differences). Adjusting for demographic factors and neighborhood safety, African Americans had lower perceived fairness compared to whites (adjusted odds ratio, aOR 0.45; 95% confidence intervals, CI 0.26-0.79; p < 0.005). Other factors associated with lower perceived fairness included Asian-language compared to English-language interview (aOR 0.29; 95% CI 0.11-0.76; p < 0.05) and lower compared to higher neighborhood safety (aOR 0.48; 95% CI 0.31-0.74; p < 0.005). Among African Americans, participants aged 18-29 years were less likely to report perceived fairness (aOR 0.06; 95% CI 0.01-0.59) compared to participants older than 60 years of age. Among Asian/Pacific Islanders, Asian-language interview (aOR 0.07; 95% CI 0.01-0.48) and lower perceived neighborhood safety (aOR 0.01; 95% CI <0.01-0.13) were associated with perceived fairness.
  
  
  CONCLUSIONS
  To strengthen bioterrorism preparedness, public health officials must continue to improve perceived fairness among African American and Asian/Pacific Islander communities.
authors.affiliation: RAND Corporation, Santa Monica, CA 90407-2138, USA. David_Eisenman@rand.org
authors.forename: David P
authors.initials: DP
authors.lastname: Eisenman
authors.forename: Cheryl
authors.initials: C
authors.lastname: Wold
authors.forename: Claude
authors.initials: C
authors.lastname: Setodji
authors.forename: Scot
authors.initials: S
authors.lastname: Hickey
authors.forename: Ben
authors.initials: B
authors.lastname: Lee
authors.forename: Bradley D
authors.initials: BD
authors.lastname: Stein
authors.forename: Anna
authors.initials: A
authors.lastname: Long
mesh_terms: D000328:Adult; D001294:Attitude to Health; D023482:Bioterrorism; D003625:Data Collection; D003695:Delivery of Health Care; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011287:Prejudice; D011634:Public Health; D011639:Public Opinion; D044469:Racial Groups; D012959:Socioeconomic Factors