Abstract
The health status for Black-Americans is worse than other ethnic groups due to less seeking of medical care. Many Black-Americans
refuse to seek medical care due to a distrust of the medical establishment. Cultural-distrust, which perpetuates medical-mistrust,
was used as the theoretical framework for this study. It has been established that medical-mistrust by the Black-American
population correlates with to the underutilization of healthcare services, resulting in inferior outcomes and increased healthcare
cost and burden to society. The study aimed to determine if age (age group or age-stratification) and medical-mistrust adversely affect
healthcare utilization in Black-Americans when controlling for gender, income, insurance status, and education level, using the
Medical Mistrust Index and Group-Based Medical Mistrust Scale as data collection tools.
Results from 148 surveys collected from Black men (n = 57) and women (n = 91) in Orlando, Florida, USA revealed a negative significant
relationship between medical-mistrust and healthcare utilization (r = -.023) when controlling for gender, income, insurance
status, and education level. Further, it was found that a non-significant bivariate relationship exists between age (r = .032) and healthcare
utilization among Black-Americans. The results indicated that Black-Americans of all age groups harbor mistrust of healthcare
on a near-equal basis per age-stratification.
This research adds to the knowledge-base that medical-mistrust discourages healthcare-seeking behaviors and decreases healthcare
utilization by the Black-American population. These findings bring to the forefront the fundamental social, policy, and attitude
changes needed to assist Black-Americans to overcome their mistrust in medicine and increase utilization of healthcare services,
which decreases the financial burden to society and avoids the emotional fallout due to unnecessary illness and premature death.
A disproportionate number of Black-American men and women are affected by obesity and diabetes. Black-Americans have a high
risk for type 2 diabetes and a high rate of diabetic complications due to poor glycemic control and racial disparities in the United
States’ healthcare system.
Thus, in the prevention, management, and treatment of type 2 diabetes, physicians and healthcare providers should be sensitive
to the persistent medical-mistrust embedded in the psyche of the Black-American population—and be aware that, even though
younger Black-Americans are living in a more inclusive society, they might still harbor mistrust of the healthcare system on par with
their older counterparts. All medical practitioners in every medical specialty should be aware of this mistrust (and how it discourages
positive healthcare-seeking behaviors) and respond accordingly.
Keywords: Black-American; Biopsychosocial; Cultural Mistrust; Diabetes; Racism
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