Mistrust in Physicians does not Explain Black-white Disparities in Primary Care and Emergency Department Utilization: The Importance of Socialization During the Jim Crow era

Cassandra L. Hua, Anthony R. Bardo, J. Scott Brown

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Purpose: Compared to whites, blacks under-utilize primary care (PC) and over-utilize emergency department (ED) services. The aim of this study is to determine whether mistrust in physicians explains these black-white disparities, and the potentially modifying influence of socialization under racially segregated health care (i.e., raised in the U.S. South during the Jim Crow era). Methods: Data come from the nationally representative Americans' Changing Lives Study (n=1,578). Poisson regression techniques are utilized to respectively model PC and ED utilization among a sample of non-Hispanic black and white adults aged forty-years and older. Conclusion: Mistrust in physicians does not explain black-white disparities in PC or ED utilization. Blacks under-utilize PC services compared to whites, net of predisposing, need, and enabling factors, but this is especially apparent among blacks who were raised in the U.S. south during the Jim Crow era and continue to reside in the South. Blacks greatly over-utilize ED services compared to whites, but this is greatest among those raised in the south during the Jim Crow era and/or those currently residing in the South.

Original languageEnglish
Pages (from-to)540-546
Number of pages7
JournalJournal of the National Medical Association
Volume110
Issue number6
DOIs
StatePublished - Dec 2018

Bibliographical note

Funding Information:
Funding: T32 training grant in the social, medical, and economic demography of aging from the National Institute on Aging NIAT32AG000139. NIA grant 1 R01 AG40199-01.

Publisher Copyright:
© 2018 National Medical Association

Keywords

  • Health disparities
  • Healthcare utilization
  • Life course
  • Medical mistrust

ASJC Scopus subject areas

  • Medicine (all)

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