Determinants of trust in health care in an older population.
OBJECTIVE
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.


METHODS
Cross-sectional survey data from the longitudinal Chicago Health and Aging Project.


METHODS
Population-based study of three communities in the Chicago area.


METHODS
African Americans (n=2,284) and non-Hispanic whites (1,354) with a mean age of 79.3.


METHODS
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.


CONCLUSIONS
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.
School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.
Natalie
N
Guerrero
Carlos F
CF
Mendes de Leon
Denis A
DA
Evans
Elizabeth A
EA
Jacobs
D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D008297:Male; D012959:Socioeconomic Factors; D035502:Trust; D044465:White People
depression; discrimination; disparities; hostility; trust