Mistrust, discrimination influence Latino health care satisfaction

Mistrust of the medical community and perceived discrimination by health care providers can affect how satisfied young adult Latinos in rural Oregon are with their health care, new research from Oregon State University shows.

Health care satisfaction, or the lack of, could influence health outcomes for patients, affect participation in programs under the new Affordable Care Act, and contribute to disparities in for Latinos, said lead researcher Daniel López-Cevallos, associate director of research for the Center for Latino/a Studies and Engagement at OSU.

"Health care reform is about people getting insurance so they have access to services, but mistrust may lead people to delay care," López-Cevallos said.

Findings of the research were published recently in "The Journal of Rural Health." The article was co-authored by S. Marie Harvey, associate dean and professor of public health, and Jocelyn T. Warren, assistant research professor in the College of Public Health and Human Sciences. Harvey received funding from the Centers for Disease Control and Prevention for the research.

Researchers surveyed 387 young adult Latinos, 18 to 25, living in rural Oregon. Patient satisfaction information was collected as part of a larger study about among young, rural Latinos. Participants were not asked about their immigration status; more than half, about 58 percent, were born outside the U.S. and the average length of U.S. residency was 13.8 years.

The majority of participants, about 73 percent, reported being moderately or very satisfied with their health care. Among those who were not satisfied, medical mistrust and perceived discrimination were identified as factors. Other factors including age and health insurance did not affect satisfaction, the study showed.

The research suggests a need to improve "cultural competency" among , from the doctors to the receptionists to the lab technicians, so Latinos are treated with respect and dignity, the researchers said. A bilingual/bicultural workforce may be more effective in addressing health issues affecting a patient.

"Trust is huge; it allows patients to disclose concerns and be honest," Harvey said. "In a previous study we conducted, young adult Latino men reported that 'confianza,' a term that encompasses trust, respect, level of communication and confidentiality, affected their access to and use of .

Efforts to enroll Latinos in health care programs under the Affordable Care Act won't be successful if patients don't feel comfortable at their doctor's office, López-Cevallos said.

"These are young, healthy adults," he said. "We want them in our health insurance pools to help average the risk and keep costs down. This is an opportunity, but we have a lot of work to do."

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