TY - JOUR
T1 - Mistrust in Physicians does not Explain Black-white Disparities in Primary Care and Emergency Department Utilization
T2 - The Importance of Socialization During the Jim Crow era
AU - Hua, Cassandra L.
AU - Bardo, Anthony R.
AU - Brown, J. Scott
N1 - Publisher Copyright:
© 2018 National Medical Association
PY - 2018/12
Y1 - 2018/12
N2 - 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.
AB - 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.
KW - Health disparities
KW - Healthcare utilization
KW - Life course
KW - Medical mistrust
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U2 - 10.1016/j.jnma.2018.01.006
DO - 10.1016/j.jnma.2018.01.006
M3 - Article
C2 - 30129502
AN - SCOPUS:85042360064
SN - 0027-9684
VL - 110
SP - 540
EP - 546
JO - Journal of the National Medical Association
JF - Journal of the National Medical Association
IS - 6
ER -