Background Racial and ethnic minoritized groups report disproportionately lower trust in the healthcare system. Lower healthcare system trust is potentially related to increased exposure to racial discrimination in medical settings, but this association is not fully understood. We examined the association between racial discrimination in medical care and trust in the healthcare system among people with and without a personal cancer history. Methods We examined racial discrimination and trust in a nationally representative American adult sample from the Health Information National Trends Survey 6. Racial discrimination was defined as any unfair treatment in healthcare based on race or ethnicity. Trust in the healthcare system (eg, hospitals and pharmacies) was grouped into low, moderate, and high trust. Multinomial logistic regression models were used to compare low and moderate trust relative to high trust in the healthcare system and estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results A total of 5,813 respondents (15% with a personal cancer history) were included 92% (n = 5,355) reported no prior racial discrimination experience during medical treatment. Prior experiences of racial discrimination were positively associated with low (OR = 6.12, 95% CI: 4.22-8.86) and moderate (OR = 2.70, 95% CI: 1.96-3.72) trust in the healthcare system, relative to high trust. Similar associations were observed when stratifying by personal cancer history. Conclusion Respondents who reported racial discrimination during medical encounters had lower trust in the healthcare system, especially respondents with a personal cancer history. Our findings highlight the need to address racial discrimination experiences during medical care to build patient trust and promote healthcare access.

中文翻译：

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患有和未患有癌症的美国成年人的种族歧视和医疗保健系统信任


背景 少数种族和族裔群体对医疗保健系统的信任度不成比例地较低。医疗保健系统信任度较低可能与医疗环境中种族歧视的增加有关，但这种关联尚未得到充分理解。我们研究了有或没有个人癌症史的人在医疗保健中的种族歧视与对医疗保健系统的信任之间的关系。方法 我们检查了健康信息国家趋势调查 6 中具有全国代表性的美国成年人样本的种族歧视和信任。种族歧视被定义为医疗保健中基于种族或民族的任何不公平待遇。对医疗保健系统（例如医院和药房）的信任分为低信任、中信任和高信任。使用多项逻辑回归模型来比较医疗保健系统中相对于高信任度的低信任度和中等信任度，并估计比值比 (OR) 和 95% 置信区间 (CI)。结果 共有 5,813 名受访者（15% 有个人癌症史）被纳入其中，其中 92% (n = 5,355) 表示在医疗期间没有种族歧视经历。相对于高信任度，先前的种族歧视经历与对医疗保健系统的低信任度（OR = 6.12，95% CI：4.22-8.86）和中度信任度（OR = 2.70，95% CI：1.96-3.72）呈正相关。当按个人癌症史进行分层时，也观察到了类似的关联。结论 在医疗遭遇中报告种族歧视的受访者对医疗保健系统的信任度较低，特别是有个人癌症病史的受访者。 我们的研究结果强调需要解决医疗保健过程中的种族歧视经历，以建立患者信任并促进医疗保健的可及性。