Minority Health and Health Equity Archive

Now showing 1 - 3 of 3

Differences in the Patterns of Health Care System Distrust Between Blacks and Whites
(2008) Armstrong, Katrina; McMurphy, Suzanne; Dean, Lorraine T.; Micco, Ellyn; Putt, Mary; Halbert, Chanita Hughes; Schwartz, J. Sanford; Sankar, Pamela; Pyeritz, Reed E.; Bernhardt, Barbara; Shea, Judy A.
CONTEXT: Although health care-related distrust may contribute to racial disparities in health and health care in the US, current evidence about racial differences in distrust is often conflicting, largely limited to measures of physician trust, and rarely linked to multidimensional trust or distrust. OBJECTIVE: To test the hypothesis that racial differences in health care system distrust are more closely linked to values distrust than to competence distrust. DESIGN: Cross-sectional telephone survey. PARTICIPANTS: Two hundred fifty-five individuals (144 black, 92 white) who had been treated in primary care practices or the emergency department of a large, urban Mid-Atlantic health system. PRIMARY MEASURES: Race, scores on the overall health care system distrust scale and on the 2 distrust subscales, values distrust and competence distrust. RESULTS: In univariate analysis, overall health care system distrust scores were slightly higher among blacks than whites (25.8 vs 24.1, p = .05); however, this difference was driven by racial differences in values distrust scores (15.4 vs 13.8, p = .003) rather than in competence distrust scores (10.4 vs 10.3, p = .85). After adjustment for socioeconomic status, health/psychological status, and health care access, individuals in the top quartile of values distrust were significantly more likely to be black (odds ratio = 2.60, 95% confidence interval = 1.03-6.58), but there was no significant association between race and competence distrust. CONCLUSIONS: Racial differences in health care system distrust are complex with far greater differences seen in the domain of values distrust than in competence distrust. This framework may be useful for explaining the mixed results of studies of race and health care-related distrust to date, for the design of future studies exploring the causes of racial disparities in health and health care, and for the development and testing of novel strategies for reducing these disparities
Racial and Ethnic Disparities in Awareness of Genetic Testing for Cancer Risk
(2009) Pagán, José A.; Su, Dejun; Li, Lifeng; Armstrong, Katrina; Asch, David A.
BACKGROUND: Racial and ethnic disparities in awareness of genetic testing for cancer risk are substantial. PURPOSE: This study assesses the relative importance of contributing factors to gaps in awareness of genetic testing for cancer risk across racial and ethnic groups. METHODS: Data from the 2005 National Health Interview Survey (N=25,364) were analyzed in 2009 to evaluate the contribution of demographic factors, SES, health status, nativity/length of residency in the U.S., personal/family history of cancer, and perceived cancer risk to racial and ethnic disparities in genetic testing awareness for cancer risk. The contribution of each factor was assessed using the Fairlie decomposition technique. RESULTS: About 48% of non-Hispanic whites reported that they had heard about genetic testing, followed by 31% of blacks, 28% of Asians, and 19% of Hispanics. Education and nativity/length of residency in the U.S. explained 26% and 30% of the gap between whites and Hispanics, respectively. Education accounted for 22% of the white-black gap, with residential region explaining another 11%. Nativity/length of residency in the U.S. explained 51% of the white-Asian gap. CONCLUSIONS: The relative importance of factors contributing to racial and ethnic disparities in genetic testing awareness is specific to the particular groups under comparison. Diverse, culturally competent approaches are needed to improve awareness for different racial and ethnic groups.
The Association Between Knowledge and Attitudes About Genetic Testing for Cancer Risk in the United States
(2005) Rose, Abigail; Peters, Nikki; Shea, Judy A; Armstrong, Katrina
Attitudes about genetic testing are likely to be an important determinant of uptake of predictive genetic tests among the general public. Several prior studies have suggested that positive attitudes about genetic testing may be inversely related to knowledge about genetic testing. We conducted a random-digit-dialing (RDD) telephone survey of 961 adults in the continental United States to determine the associations among knowledge of, attitudes about, and perceptions of eligibility for genetic testing for cancer risk. Knowledge about genetic testing for cancer risk was generally high, with a mean accuracy score of 72%. Attitudes about genetic testing for cancer risk were also generally positive, with 87% of respondents reporting genetic testing for cancer risk would be used to help doctors manage their health care and 85% to help scientists find cures for diseases. In contrast, 58% of respondents thought genetic testing for cancer risk would be used to prevent them from getting health insurance and 31% to allow the government to label groups as inferior. Twenty-nine percent of respondents thought they were currently eligible for testing. After adjustment for sociodemographic characteristics and family cancer history, higher knowledge was correlated with more positive attitudes about testing, but not with negative attitudes or perceptions of testing eligibility. Family history was positively associated with perceptions of eligibility (OR 3.49, 95%CI 2.36–5.18), and higher levels of education were inversely associated with perceptions of eligibility (OR 0.55, 95%CI 0.32–0.94 for comparison of college or higher vs. less than high school). These results suggest that most members of the general public are knowledgeable and have positive attitudes about genetic testing for cancer risk and that greater knowledge is correlated with more positive attitudes about the benefits of testing.

Minority Health and Health Equity Archive

Browse

Filters

Settings

Sort By

Results per page

Search Results