Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #113778

Jacqueline Wiltshire, MPH, PhD¹, Chimnonso Njokanma, BS², and Kate A. Cronin, MPH². (1) Center for Women's Health Research, University of Wisconsin-Madison, Meriter Hospital, 6 West, 202 S. Park Street, Madison, WI 53715, (2) National Centers and Community Centers of Excellence in Women's Health Research Coordinating Center, University of Wisconsin-Madison, Meriter Hospital, 6 West, 202 S. Park Street, Madison, WI 53593, 608-267-5572, canjokanma@wisc.edu

Background: Research shows that African Americans are less likely to trust their physicians.¹ However, little distinction is made among the various vulnerable sub-groups within this population.

Objective: To examine how vulnerable sub-groups of African Americans women view physician trust.

Methods: Data were drawn from the 2000-2001 Household Component of the Community Tracking Study, a nationally representative survey. Sub-groups examined were: poor/near poor (0-199% of federal poverty level), poor/fair health, elderly (65+), and under-educated (<12 years of education) and uninsured. The sample included 2,953 African American women aged 18+ who have a usual physician and had at least one visit in the previous 12 months. Four measures of physician trust were examined: 1) physician may not refer when needed, 2) physician puts medical needs above all other considerations, 3) physician influenced by insurance rules, and 4) physician perform unnecessary tests or procedures. Average scores on the four measures were calculated for each respondent. A dichotomous measure was created with average scores <4 as "lack of trust" and ≥4 as having trust. Logistic regressions accounted for survey design and possible confounders.

Results: Overall, 21.2% of respondents reported "lack of trust" in their physicians. "Lack of trust" was highest among the poor/near poor and the uninsured groups (27.3 % and 27%, respectively). The most negative response was for the measure “physician influenced by insurance company rules,” with the poor/near poor group reporting the most negative response and the undereducated group the least negative response. The measure with the least negative response was “physician doesn't put needs above all considerations,” with the elderly group giving the least negative response and the uninsured group giving the most negative response. Adjusted, “lack of trust” in physicians was highest among the uninsured and the poor/near poor groups (OR=1.79, 95% CI: 1.22-2.63 and OR=1.68, 95% CI: 1.35-2.09, respectively). There were no significant differences in “lack of trust” in physicians in the elderly compared to the young, poor/fair health compared to the good/excellent health, and the undereducated compared to the educated.

Conclusions: African American women differ in their perceptions of physician based on age, socioeconomic status, and insurance status. The findings suggest that the physician distrust is influenced primarily by factors linked to insurance and ability to afford care.

Learning Objectives: At the end of the session, the participant will be able to

• Identify sub-groups of African American women who are most likely to be distrustful of their physicians.
• Identify factors that influence African American women's perception of their physicians.
• Recognize that African American women have variations in trust with their physcicians.

Keywords: Health Disparities, African American

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.