Affordability, negative experiences, perceived racism, and health care system distrust among black American women aged 45 and over
Black Americans (AA) face a confluence of challenges when seeking care including unaffordable costs, negative experiences with providers, racism, and distrust in the healthcare system. This study utilized linear regressions and mediation analysis to explore the interconnectedness of these challenges...
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| Format: | Article |
| Language: | English |
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AIMS Press
2024-09-01
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| Series: | AIMS Public Health |
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| Online Access: | https://www.aimspress.com/article/doi/10.3934/publichealth.2024053 |
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| _version_ | 1832590291286097920 |
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| author | Jacqueline Wiltshire Carla Jackie Sampson Echu Liu Myra Michelle DeBose Paul I Musey Keith Elder |
| author_facet | Jacqueline Wiltshire Carla Jackie Sampson Echu Liu Myra Michelle DeBose Paul I Musey Keith Elder |
| author_sort | Jacqueline Wiltshire |
| collection | DOAJ |
| description | Black Americans (AA) face a confluence of challenges when seeking care including unaffordable costs, negative experiences with providers, racism, and distrust in the healthcare system. This study utilized linear regressions and mediation analysis to explore the interconnectedness of these challenges within a community-based sample of 313 AA women aged 45 and older. Approximately 23% of participants reported affordability problems, while 44% had a negative experience with a provider. In the initial linear regression model excluding perceived racism, higher levels of distrust were observed among women reporting affordability problems (β = 2.66; p = 0.003) or negative experiences with a healthcare provider (β = 3.02; p = <0.001). However, upon including perceived racism in the model, it emerged as a significant predictor of distrust (β = 0.81; p = < 0.001), attenuating the relationships between affordability and distrust (β = 1.74; p = 0.030) and negative experience with a provider and distrust (β = 1.79; p = 0.009). Mediation analysis indicated that perceived racism mediated approximately 35% and 41% of the relationships between affordability and distrust and negative experience with a provider and distrust, respectively. These findings underscore the critical imperative of addressing racism in the efforts to mitigate racial disparities in healthcare. Future research should explore the applicability of these findings to other marginalized populations. |
| format | Article |
| id | doaj-art-e1c29a63c63246a1be6c7e9ddbc60fed |
| institution | Kabale University |
| issn | 2327-8994 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | AIMS Press |
| record_format | Article |
| series | AIMS Public Health |
| spelling | doaj-art-e1c29a63c63246a1be6c7e9ddbc60fed2025-01-24T01:32:41ZengAIMS PressAIMS Public Health2327-89942024-09-011141030104810.3934/publichealth.2024053Affordability, negative experiences, perceived racism, and health care system distrust among black American women aged 45 and overJacqueline Wiltshire0Carla Jackie Sampson1Echu Liu2Myra Michelle DeBose3Paul I Musey4Keith Elder5Indiana University Fairbanks School of Public Health, Indianapolis, IN USARobert F. Wagner Graduate School of Public Service, New York University, NY USACollege for Public Health and Social Justice, Saint Louis University, MO USACollege of Nursing and School of Allied Health, Northwestern State University, LA USAIndiana University School of Medicine, Indianapolis, IN USASaint Xavier University, Chicago, IL USABlack Americans (AA) face a confluence of challenges when seeking care including unaffordable costs, negative experiences with providers, racism, and distrust in the healthcare system. This study utilized linear regressions and mediation analysis to explore the interconnectedness of these challenges within a community-based sample of 313 AA women aged 45 and older. Approximately 23% of participants reported affordability problems, while 44% had a negative experience with a provider. In the initial linear regression model excluding perceived racism, higher levels of distrust were observed among women reporting affordability problems (β = 2.66; p = 0.003) or negative experiences with a healthcare provider (β = 3.02; p = <0.001). However, upon including perceived racism in the model, it emerged as a significant predictor of distrust (β = 0.81; p = < 0.001), attenuating the relationships between affordability and distrust (β = 1.74; p = 0.030) and negative experience with a provider and distrust (β = 1.79; p = 0.009). Mediation analysis indicated that perceived racism mediated approximately 35% and 41% of the relationships between affordability and distrust and negative experience with a provider and distrust, respectively. These findings underscore the critical imperative of addressing racism in the efforts to mitigate racial disparities in healthcare. Future research should explore the applicability of these findings to other marginalized populations.https://www.aimspress.com/article/doi/10.3934/publichealth.2024053healthcare affordabilitynegative experiencesracismhealthcare systemdistrustafrican american women |
| spellingShingle | Jacqueline Wiltshire Carla Jackie Sampson Echu Liu Myra Michelle DeBose Paul I Musey Keith Elder Affordability, negative experiences, perceived racism, and health care system distrust among black American women aged 45 and over AIMS Public Health healthcare affordability negative experiences racism healthcare system distrust african american women |
| title | Affordability, negative experiences, perceived racism, and health care system distrust among black American women aged 45 and over |
| title_full | Affordability, negative experiences, perceived racism, and health care system distrust among black American women aged 45 and over |
| title_fullStr | Affordability, negative experiences, perceived racism, and health care system distrust among black American women aged 45 and over |
| title_full_unstemmed | Affordability, negative experiences, perceived racism, and health care system distrust among black American women aged 45 and over |
| title_short | Affordability, negative experiences, perceived racism, and health care system distrust among black American women aged 45 and over |
| title_sort | affordability negative experiences perceived racism and health care system distrust among black american women aged 45 and over |
| topic | healthcare affordability negative experiences racism healthcare system distrust african american women |
| url | https://www.aimspress.com/article/doi/10.3934/publichealth.2024053 |
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