Predictors of medical mistrust among urban youth of color during the COVID-19 pandemic

Abstract

The COVID-19 pandemic has disproportionately impacted communities of color and highlighted longstanding racial health inequities. Communities of color also report higher rates of medical mistrust driven by histories of medical mistreatment and continued experiences of discrimination and systemic racism. Medical mistrust may exacerbate COVID-19 disparities. This study utilizes the Behavior Model for Vulnerable Populations to investigate predictors of medical mistrust during the COVID-19 pandemic among urban youth of color. Minority youth (N = 105) were recruited from community organizations in Kansas City, Missouri to complete an online survey between May and June 2020. Multiple linear regressions were performed to estimate the effect of personal characteristics, family and community resources, and COVID-19 need-based factors on medical mistrust. Results indicated that loneliness, financial insecurity (e.g., job loss, loss of income) due to the COVID-19 pandemic, and eligibility for free or reduced lunch predicted medical mistrust. Insurance status, neighborhood median household income, social support, and perceived COVID-19 risk were not significantly associated with medical mistrust. Future research and policies are necessary to address systemic factors that perpetuate medical mistrust among youth of color.

Health Equity Tourism: Ravaging the Justice Landscape

“…This is in stark opposition to two-well developed bodies of scientific literature; 1) that social inequities are among the main drivers of infectious disease burden [10,11], and 2) that race is not a meaningful grouping for genetic similarity [12,13]. Thankfully, and perhaps because of the recent interest in racial equity, strong studies have materialized that actually interrogate how social inequities cause disproportionate mortality burden in covid-19, including hospital system segregation [14], sequestration of racially oppressed groups into occupations with high transmission risk [15][16][17][18] and medical mistrust [19][20][21]. However, this speaks to another ramification of equity tourism, dilution.…”

COVID‐19 shines a light on health inequities in communities of color: A youth‐driven photovoice inquiry

“…Health inequities in communities of color have long existed before the pandemic (Ottersen et al, 2014 ). However, COVID‐19 merely highlighted and exacerbated these deep inequities (Ash et al, 2021 ). Not only were these health inequities driven by the lack of critical resources and protections in communities of color, but also, and perhaps just as importantly by the way that the pandemic has been messaged—further driving medical distrust in communities of color.…”

“…It presents visual data collected and analyzed by youth researchers in partnership with adult facilitators. The study is timely in that research demonstrates that COVID‐19 disproportionately impacts low‐income and communities of color (Ash et al, 2021 ). Further, distrust in medical professionals and medical systems results in, among other things, worse outcomes for patients—further perpetuating health inequities (Alpers, 2018 ).…”

Screening Families in Primary Care for Social and Economic Needs: Patients’ Urgency and Activation for Social Care Navigation

“…Thus, families' interest and engagement in social needs navigation may reflect not only their attitudes toward SDoH but families' (dis)trust in healthcare institutions as influenced by local culture, structural racism, and experiences of bias and discrimination in healthcare settings. [35][36][37] Limitations of the SDoH registry and lack of integration with the electronic medical record precluded more detailed assessment of which groups obtaining care within the practices (e.g., parents of younger versus older children, women with particular comorbidities) were more or less likely to identify their needs as urgent or to engage with the team. Future work is needed to better understand reported social needs and the particular reasons families sought care.…”