Racial differences in social support and medical mistrust on utilization of health care services

Research has identified mistrust of medical care as a factor shaping the health behavior of Blacks and contributing to documented inequality in health status. Mistrust of medicine is associated with negative perceptions toward medical care and less frequent visits to health care centers. Our study examines the influence of social support and mistrust of medical care on utilization of health care services among Black and White adults. Methods: We use data from the Greater Pittsburgh Randomized Household Health Survey to investigate social support and mistrust of medicine among 347 white and 671 black respondents. Standardized measures included social support, medical mistrust, use of preventive health services, perceived quality of health care, and discrimination experienced in seeking medical care. Results: Forty-six percent of the sample was male. The age range was 18-97 years (mean age = 50.96). Preliminary analysis demonstrates that Blacks had significantly fewer relatives and friends that they can call upon for help and to discuss private matters compared to Whites (p=.000). Blacks were significantly less willing to participate in future medical research with 35% of Blacks answering they probably would participate as compared to 50% of Whites. Blacks were also more likely to trust the health information received from churches/religious leaders with 28% of Blacks responding they definitely would trust information as compared to 20% of Whites. Social support was positively correlated with perceived quality of care and location of medical services across both racial groups. Increased family support was positively correlated with receiving most medical care at a private doctor's office (p=.000), while increased friend support was positively correlated with receiving most medical care at a private doctors office (p=.000), and school or student health services. Discrimination experienced in the medical setting was negatively correlated with receiving most medical care at a private doctor's office (p=.000), and positively correlated with receiving medical care at a community health clinic (p=.008), hospital (p=.043), and home (p=.037) across both groups. Moreover, higher perceived quality (p=.000) and lower reports of discrimination experienced in the medical setting (p=.001) were significantly associated with participants going to a health care provider when they needed to. Implications: Medical mistrust is a multifaceted concept that is affected by individual and social factors. By understanding racial differences in social support at the individual level, researchers and health care professionals can better understand the mechanisms fueling mistrust in medical care and influencing utilization of health care services.