Study finds high level of medical mistrust among minority women impacts quality of health care

February 5, 2009,

Nearly 70 percent of minority women agree that health-care organizations sometimes deceive or mislead patients, one of the key findings of a Michigan State University study that researchers say can prevent women from getting breast cancer screenings.

The study of 341 Arab-American, African-American and Latina women was created to examine levels of medical mistrust and assess the impact on whether the participants received recommended breast cancer screenings, said Karen Patricia Williams, lead author and an assistant professor of obstetrics, gynecology and reproductive biology in MSU's College of Human Medicine.

Williams presented her work at the American Association for Cancer Research's conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved, which was held Feb 3 to Feb. 6 in Arizona. The study was funded by Susan G. Komen for the Cure in Dallas.

"This study reveals an important association between medical mistrust and appropriately timed breast cancer screening among many minority women," Williams said. "We found high levels of mistrust, regardless of the racial-ethnic group. People are less likely to engage in preventive screening practices, thereby making them more likely to suffer from conditions such as breast cancer that if caught early could be better treated."

Williams added the findings also show many minority women only will use the health-care system when they are very sick, a medical behavior that taxes the health-care system.

The women in the study answered questions as part of a seven-item Medical Mistrust Index; data on breast cancer screenings and socio-demographics also were collected.

Among other findings:

• African-American women were found to have higher levels of mistrust; 39 percent strongly agreed that health-care organizations don't keep information private, compared to 15 percent for Latina women and 9 percent for Arab-American women.

• 44 percent of women who had never received a clinical breast exam agreed that health-care organizations have sometimes done harmful experiments on patients without their knowledge.

• 64 percent of women who had not received a breast exam in the past 12 months agreed with the statement that they sometimes wonder if health-care organizations really know what they are doing.

Williams said mistrust can come from a variety of places, most notably from personal and family experience, from how a patient is cared for by a doctor to how they are treated by a receptionist. What is vital is addressing and overcoming that mistrust, Williams said.

"Everyone involved in the health-care experience needs to focus on respecting the patient and family, regardless of their race, gender, ethnicity, insurance or lack thereof," she said. "We need to provide everyone with the same gold standard regardless of any other factors."

Williams plans to publish a paper on her research and explore whether interventions using community health workers can make a difference in decreasing medical mistrust.

Source: Michigan State University

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