Healthcare distrust among hospitalised black patients during the COVID-19 pandemic

Abstract

Study purposeDistrust of the healthcare system is longstanding in the black community. This may especially threaten the health of the population when a highly contagious infection strikes. This study aims to compare COVID-19-related perspectives and behaviours between hospitalised black patients who trust versus distrust doctors and healthcare systems.Study designCross-sectional study at a tertiary care academic hospital in Baltimore, Maryland. Hospitalised adult black patients without a history of COVID-19 infection were surveyed between November 2020 and March 2021 using an instrument that assessed COVID-19-related matters. Analyses compared those who trusted versus mistrusted doctors and healthcare systems.Results37 distrusting hospitalised black patients were compared with 103 black patients who trusted doctors and healthcare systems. Groups had similar sociodemographics (all p>0.05). Distrustful patients were less likely to think that they were at high risk of contracting COVID-19 (54.0% vs 75.7%; p=0.05), less likely to believe that people with underlying medical conditions were at higher risk of dying from the virus (86.4% vs 98.0%; p=0.01) and less likely to be willing to accept COVID-19 vaccination (when available) (51.3% vs 77.6%; p<0.01) compared with those who were trusting.ConclusionHealthcare distrustful hospitalised black patients were doubtful of COVID-19 risk and hesitant about vaccination. Hospitalisations are concentrated exposures to the people and processes within healthcare systems; at these times, seizing the opportunity to establish meaningful relationships with patients may serve to gain their trust.

Factors Associated With Parental Acceptance of COVID-19 Vaccination: A Multicenter Pediatric Emergency Department Cross-Sectional Analysis

“…Yet, in isolation, these efforts may not suffice. [33][34][35] Belief in whether the vaccine will work may be grounded in trust in the scientific community, a factor we found to be highly associated with vaccine acceptance. For the scientific community to engender trust, full disclosure of both benefits and risks of the vaccine is essential.…”

Racial disparities in surgical treatment of oropharyngeal cancer: A Surveillance, Epidemiology, and End Results review

“…27 The significant mistrust between minority populations and their healthcare was made more publically visible by the COVID-19 pandemic, which demonstrated in stark terms the enduring reality of the disparity in healthcare across US populations. 28,29 Within the literature, this mistrust has been confirmed among black patients and other communities of color. 12,[30][31][32] The aforementioned events highlight a more sinister process that may add to the disparities seen-racism.…”

“…Historically, the literature points to trials such as the Tuskegee Syphilis study as a core reason for mistrust among black patients and the healthcare system 27 . The significant mistrust between minority populations and their healthcare was made more publically visible by the COVID‐19 pandemic, which demonstrated in stark terms the enduring reality of the disparity in healthcare across US populations 28,29 . Within the literature, this mistrust has been confirmed among black patients and other communities of color 12,30–32 …”

Medication Regimen Complexity Index Score at Admission as a Predictor of Inpatient Outcomes: A Machine Learning Approach

“…A significant statistical disproportion was found with Blacks in our study making up 35.4% of the sample. Research has also shown that minorities are often, compared to Whites, at increased risk for chronic diseases [ 56 ]. Societal and systemic sources describe the unequal probability of having members of a specific racial group as a patient in our sample, perhaps due to strict patient selection or assessment of patient compliance, baseline health status, and comorbidities [ 55 ].…”