Masculinity, Medical Mistrust, and Preventive Health Services Delays Among Community-Dwelling African-American Men

Hammond, Wizdom Powell; Matthews, Derrick D.; Mohottige, Dinushika; Agyemang, Amma A.; Corbie-Smith, Giselle

doi:10.1007/s11606-010-1481-z

Cited by 184 publications

(180 citation statements)

References 62 publications

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“…[14][15][16] For that reason, medical mistrust has been proposed as a potential explanation for and point of future exploration into the usual source of care disparity. [12][13][14][15][16][17] Long-considered an explanation for African-Americans' reluctance to participate in medical research, medical mistrust has recently been correlated with higher rates of ED utilization, lower rates of preventive services, and fewer health-seeking behaviors. 13,14,17 Emerging evidence suggests that residential segregation may confound the relationship between medical mistrust and healthcare utilization.…”

Section: Medical Mistrustmentioning

confidence: 99%

“…[12][13][14][15][16][17] Long-considered an explanation for African-Americans' reluctance to participate in medical research, medical mistrust has recently been correlated with higher rates of ED utilization, lower rates of preventive services, and fewer health-seeking behaviors. 13,14,17 Emerging evidence suggests that residential segregation may confound the relationship between medical mistrust and healthcare utilization. [18][19][20][21] To the best of our knowledge, no study explores the relationship between medical mistrust and usual source of care while controlling for confounding of race and residential segregation.…”

Section: Medical Mistrustmentioning

confidence: 99%

“…[12][13][14][15][16][17] Few studies have empirically investigated African-Americans' mistrust of healthcare organizations at distinct ecological levels (i.e., health clinics, hospitals, insurance companies, and public health departments). Future investigations into such patterns of medical mistrust may be enlightening.…”

Section: Main Independent Variablesmentioning

confidence: 99%

“…The role medical mistrust plays in the usual source of care disparity may be explained by conceptualizing medical mistrust as a barrier to healthcare utilization. 14,17,37 In general, perceived barriers to healthcare utilization predispose patients to use the ED as their site of usual source of care. 37 More specifically, studies have established that The values which are represented with ± are means ± SD.…”

Section: Emergency Department As a Usual Source Of Carementioning

confidence: 99%

“…14,17 It follows that less preventive care leads to higher occurrence of medical issues (urgent or non-urgent), which might have been prevented. 8 In the absence of an established relationship with a PC facility, the ED offers the most immediate access to a medical professional.…”

Section: Emergency Department As a Usual Source Of Carementioning

confidence: 99%

See 4 more Smart Citations

Race, Medical Mistrust, and Segregation in Primary Care as Usual Source of Care: Findings from the Exploring Health Disparities in Integrated Communities Study

et al. 2016

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Compared to White Americans, African-Americans are less likely to use primary care (PC) as their usual source of care. This is generally attributed to race differences in socioeconomic status and in access to primary care services. Little is known about the relationship between race differences in medical mistrust and the usual source of care disparity. Using data from the Exploring Health Disparities in Integrated Communities (EHDIC) study, we examined the role of medical mistrust in choosing usual source of care in 1408 black and white adults who were exposed to the same healthcare facilities and low-income racially integrated community. Multinomial logistic regression models were estimated to examine the relationship between race, medical mistrust, and usual source of care. After adjusting for demographic and health-related factors, African-Americans were more likely than whites to use the emergency department (ED) (relative risk ratio [RRR] = 1.43 (95 % confidence interval (CI) [1.06-1.94])) and hospital outpatient department (RRR1.50 (95 %CI [1.10-2.05])) versus primary care as a usual source of care. When medical mistrust was added to the model, the gap between African-Americans' and whites' risk of using the ED versus primary care as a usual source of care closed (RRR = 1.29; 95 % CI [0.91-1.83]). However, race differences in the use of the hospital outpatient department remained even after accounting for medical mistrust (RRR = 1.67; 95 % CI [1.16-2.40]). Accounting for medical mistrust eliminated the ED-as-usual-source of care disparity. This study highlights the importance of medical mistrust as an intervention point for decreasing ED use as a usual source of care by low-income, urban African-Americans.

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