Abstract
BACKGROUND: When providing healthcare services to diverse populations of middle-aged and older adults, it is important to understand factors that may influence the amount of trust they have in their doctors, such as demographic factors and previous experiences of discrimination. OBJECTIVE: We examined correlates of general trust in doctors in a national sample of adults in the USA. DESIGN: The REGARDS longitudinal cohort study included measures of trust in doctors and discrimination at a follow-up visit. Cross-sectional sequential linear regression models, with general trust in doctors as the outcome, first included demographic factors and then added discrimination in a medical care setting. PARTICIPANTS: The baseline REGARDS sample included community-dwelling participants across the contiguous USA who identified as White or Black/African American and were aged 45 or older. Our analytic sample included 8500 participants who completed the second in-home REGARDS visit and were aged 52 years or older. MAIN MEASURES: Trust was measured by the General Trust in Doctors Scale. Participants also reported whether they had ever experienced discrimination in a medical care setting. KEY RESULTS: Female sex (b = -1.41, p < 0.05), Black/African American race (b = -0.40, p < 0.05), and having a higher level of education (b = -0.45, p < 0.05) were each independently related to lower trust in doctors. Older age (b = 0.10, p < 0.05) was associated with higher trust. Previous discrimination had a negative association with trust (b = -4.27, p < 0.05) and the relationship between race and trust was reduced to zero (b = 0.28, p = 0.155) with discrimination in the model. CONCLUSIONS: Previous discrimination experiences in a medical care setting completely attenuated the relationship between race and trust in doctors, a prominent finding that should be considered when providing healthcare services to diverse populations of adults.