Impact of sociodemographic factors and previous interactions with the health care system on institutional trust in three racial/ethnic groups

- We explored whether institutional trust in healthcare differed across racial/ethnic group.
- We explored what factors might contribute to these differences.
- African Americans and Mexican-Hispanic respondents were less trusting than whites.
- The only other factor related to lower trust was a previous negative health care experience.

ObjectiveOur objective was to explore whether there are differences in institutional trust across racial/ethnic groups and what factors might contribute to these differences.MethodsWe studied a convenience sample of 569 adults in Chicago grocery stores who self-identified as African American, Mexican-Hispanic, or white. We measured institutional trust and dichotomized responses into “high” and “low” trust. We used chi squared tests to examine differences in institutional trust across racial/ethnic groups and stepwise multivariable logistic regression to investigate how sociodemographic factors, health care access, health care usage, and previous negative experience with the health care system modified this relationship.ResultsIn unadjusted analysis, race/ethnicity was significantly associated with institutional trust (p < 0.001). In the fully adjusted model, African Americans and Mexican-Hispanics had greater odds of reporting low trust compared to whites (OR: 1.90; 95%CI, 1.13-3.17; and OR: 2.34; 95%CI, 1.43-3.81, respectively); reporting a previous negative health care experience was the only other factor significantly related to having low trust (OR: 2.84; 95%CI, 1.83-4.41).ConclusionWe found lower institutional trust in African Americans and Mexican-Hispanics and among participants reporting previous negative health care experiences.Practice implicationsImproving health care experiences, especially for racial/ethnic minority groups, could improve institutional trust and decrease health disparities in these populations.