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.
|Number of pages
|Journal of the National Medical Association
|Published - Dec 2018
Bibliographical noteFunding 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.
© 2018 National Medical Association
- Health disparities
- Healthcare utilization
- Life course
- Medical mistrust
ASJC Scopus subject areas
- Medicine (all)