Recorded presentation

Cheryl Wold, MPH¹, David P. Eisenman, MD, MSHS², Anna Long, PhD, MPH³, Claude Setodji, PhD², Scot Hickey², and Benedict Lee, PhD¹. (1) Office of Health Assessment and Epidemiology, Department of Health Services, Los Angeles County, 313 North Figueroa St. Room 127, Los Angeles, CA 90012, (213) 240-7785, cwold@dhs.co.la.ca.us, (2) RAND Health, RAND Corporation, 1700 Main Street, POB 2138, Santa Monica, CA 90407-2138, (3) Chief of Staff, Public Health, L. A. County Dept. of Health Services, 313 N. Figueroa Street, Room 909, Los Angeles, CA 90012

Background: Public health’s responses to bioterrorism will require community trust in their institutions and actions. We describe variations in trust by race/ethnicity and other factors, in a large U.S. metropolitan population.

Methods: We analyzed the Los Angeles County Health Survey, a random-digit-dialed telephone survey of 8,127 non-institutionalized adults in Los Angeles County, completed October-January 2003. A random sub-sample (n=1,041) answered questions regarding terrorism. The outcome variable (trust) was an affirmative response to the item: “If there is a bioterrorist attack in LA, do you think the County’s public health system will respond fairly to your health needs regardless of race, ethnicity, income or other personal characteristics?” We assessed the outcome prevalence by race/ethnicity and other factors and performed multivariate logistic regression predicting trust, controlling for these factors.

Results: Trust was associated with race/ethnicity (whites 77%, Latinos 73%, Asian and Pacific Islander (API)68%, and African-Americans(AA)63%; p=0.001); interview language (English 80% Spanish 86%, Asian languages 62%; p=0.01), and perceived neighborhood safety (not safe 63%, somewhat unsafe 78%, somewhat safe 81%, very safe 84%; p=0.01.) AAs were less likely than whites to endorse trust (OR 0.4; 95% CI 0.2—0.7). Predictors of trust were AA (0.5; 95% CI 0.3—0.9), Asian language (0.3; 95% CI 0.1—0.7) and perceived neighborhood safety (1.4; 95% CI 1.1—1.7).

Conclusions: Trust in public health to respond fairly to bioterrorism was lower among AAs, APIs, Asian language groups, and residents of unsafe neighborhoods. Public health must continue to develop institutional trust with AA and API communities.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

1.List sociodemographic and neighborhood factors that are associated with lower trust of public health to respond fairly to bioterrorism. 2.Articulate factors within racial/ethnic groups that are associated with lower trust of public health to respond fairly to bioterrorism.
• Discuss the value of population-based assessments of various communities to public health preparedness and response to bioterrorism.

Keywords: Bioterrorism, Vulnerable Populations

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation