Research ArticleOriginal Research

Associations Between Patient/Caregiver Trust in Clinicians and Experiences of Healthcare-Based Discrimination

Arshdeep Kaur, Laura M. Gottlieb, Stephanie Ettinger de Cuba, Elena Byhoff, Eric W. Fleegler, Alicia J. Cohen, Nathaniel J. Glasser, Mark J. Ommerborn, Cheryl R. Clark and Emilia H. De Marchis
The Journal of the American Board of Family Medicine July 2024, 37 (4) 607-636; DOI: https://doi.org/10.3122/jabfm.2023.230182R1

Article Figures & Data

Tables

  • Table 1.

    Sample Characteristics by Level of Trust in Healthcare Provider

    n (%)
    TotalLow/Medium Trust
    (1–7)
    (n = 197)    		High Trust
    (8–10)
    (n = 815)    		P-value
    Biological sex (n = 998)
     Female701 (70)136 (19)565 (81)0.96
     Male297 (30)58 (20)239 (80)
    Race and ethnicity (n = 957)
     Non-Hispanic White357 (37)48 (13)309 (87)0.001
     Non-Hispanic Black207 (22)54 (26)153 (74)
     Hispanic310 (32)70 (23)240 (77)
     Non-Hispanic multiple/other83 (9)15 (18)68 (82)
    Age (n = 1,003)
     18 to 44541 (54)116 (21)425 (79)0.25
     45 to 64301 (30)51 (17)250 (83)
     65+161 (16)29 (18)132 (82)
    Years of education (n = 1,005)
     Less than 12 years170 (17)37 (22)133 (78)0.44
     12 or more years835 (83)160 (19)675 (81)
    Income (n = 857)
     $0–50k595 (69)136 (23)459 (77)<0.001
     $50,001–75k82 (10)7 (9)75 (92)
     $75,001+180 (21)23 (13)157 (87)
    SES ladder position* (n = 922)5.66 (2.23)5.06 (2.11)5.80 (2.23)<0.001
    Healthcare setting (n = 1,012)
     Primary care620 (61)118 (19)502 (81)0.66
     Emergency department392 (39)79 (20)313 (80)
    Site type (n = 1,012)
     Urban academic720 (71)146 (20)574 (80)0.56
     Urban non-academic97 (10)18 (19)79 (81)
     Non-urban non-academic195 (19)33 (17)162 (83)
    Percentage publicly insured/uninsured at site (n = 1,012)
     Less than 80% publicly insured/uninsured725 (72)132 (18)593 (82)0.11
     80% or more publicly insured/uninsured287 (28)65 (23)222 (77)
    Participant type (n = 1,012)
     Adult patient781 (77)151 (19)630 (81)0.85
     Caregiver of pediatric patient231 (23)46 (20)185 (80)
    Preferred language (n = 1,012)
     English845 (83)167 (20)678 (80)0.59
     Spanish167 (17)30 (18)137 (82)
    Patient/caregiver-reported health (n = 985)
     Poor, Fair230 (23)69 (30)161 (70)<0.001
     Good, Very Good, Excellent755 (77)119 (16)636 (84)
    Experienced any of 7 categories perceived discrimination (n = 1,002)
     Yes275 (27)98 (36)177 (64)<0.001
     No727 (73)96 (13)631 (87)
    Healthcare discrimination score * (n = 927)0.78 (1.65)1.65 (2.15)0.57 (1.43)<0.001
    Asked about needs in any domains in the past 12 months (n = 993)
     Yes307 (31)63 (21)244 (80)0.60
     No686 (69)131 (19)555 (81)
    Assisted with needs in any domains in the past 12 months (n = 993)
     Yes174 (18)48 (28)126 (72)0.003
     No819 (82)145 (18)674 (82)

    • *mean (S.D.).

    • Abbreviation: SES, socioeconomic status.

  • Table 2.

    Trust in Healthcare Provider and Experiences of Healthcare Discrimination by Race and Ethnicity

    n (%)
    TotalNon-Hispanic White (n = 367)Non-Hispanic Black (n = 212)Hispanic (n = 329)Non-Hispanic Multiple/ Other (n = 84)P-value
    Low/medium trust (1 to 7)187 (20)48 (13)54 (26)70 (23)15 (18)0.001
    High trust (8 to 10)770 (81)309 (87)153 (74)240 (77)68 (82)
    Experienced any of 7 categories perceived discrimination268 (27)94 (26)67 (32)75 (23)32 (38)0.01
    Item 1: Felt like a doctor or nurse was not listening to what you were saying183 (19)54 (15)47 (23)59 (18)23 (27)0.02
    Item 2: Treated you with less respect than other people123 (13)40 (11)38 (18)28 (9)17 (20)0.001
    Item 3: Received poorer services than other people93 (10)25 (7)34 (17)20 (6)14 (17)<0.001
    Item 4: Treated with less courtesy than other people107 (11)34 (9)28 (14)29 (9)16 (19)0.03
    Item 5: Had a doctor or nurse act as if he or she was better than you117 (12)50 (14)30 (15)21 (7)16 (20)0.001
    Item 6: Had a doctor or nurse act as if he or she thinks you were not smart122 (13)52 (14)33 (16)24 (7)13 (16)0.006
    Item 7: Had a doctor or nurse act as if he or she was afraid of you31 (3)6 (2)16 (8)3 (1)6 (7)<0.001
  • Table 3.

    Adjusted Associations Between High Trust in Healthcare Provider and Variables of Interest (n = 690)

    Adjusted Odds Ratio (95% CI)
    Healthcare discrimination score0.74 (0.64, 0.85)
    Race and ethnicity
     Non-Hispanic White (reference)
     Non-Hispanic Black0.56 (0.27, 1.17)
     Hispanic0.67 (0.30, 1.52)
     Non-Hispanic multiple/other0.96 (0.39, 2.72)
    Age
     18 to 44 (reference)
     45 to 641.30 (0.82, 2.06)
     65+1.05 (0.39, 2.81)
    Education 12 or more years0.62 (0.36, 1.05)
    Income
     $0–50k (reference)
     $50,001–75k2.19 (0.82, 5.84)
     $75,001+1.41 (0.90, 2.22)
    SES ladder1.04 (0.92, 1.16)
    Self-rated health good, very good, or excellent3.15 (2.01, 4.92)
    Interaction: Self-rated health * discrimination score0.84 (0.74, 0.96)
    80% or more publicly insured/uninsured0.76 (0.52, 1.12)
    Previously screened for social risks in prior 12 months0.99 (0.63, 1.55)
    Interaction: Previously screened * discrimination score1.28 (1.03, 1.58)
    Previously assisted with social risks in prior 12 months0.86 (0.60, 1.23)

    • Abbreviations: SES, socioeconomic status; CI, confidence interval.

  • Table 4.

    Adjusted Associations Between High Trust in Healthcare Provider and Variables of Interest, Stratified by Race and Ethnicity

    Adjusted Odds Ratio (95% CI)
    Non-Hispanic White (n = 275)Non-Hispanic Black (n = 161)Hispanic (n = 196)Non-Hispanic Multiple/Other (n = 48)
    Healthcare discrimination score0.80 (0.63, 1.00)0.71 (0.53, 0.96)0.52 (0.40, 0.68)0.57 (0.24, 1.37)
    Age
     18 to 44 (reference)
     45 to 641.27 (0.72, 2.22)1.21 (0.46, 3.18)0.85 (0.23, 3.19)7.63 (0.67, 87.08)
     65+1.21 (0.65, 2.25)1.18 (0.15, 9.26)0.71 (0.27, 1.88)0.42 (0.01, 28.58)
    Education 12 or more years0.90 (0.12, 7.12)1.72 (0.80, 3.68)0.15 (0.05, 0.42)0.70 (0.04, 12.82)
    Income
     $0–50k(reference)
     $50,001–75k2.48 (0.45, 13.69)2.30 (1.01, 5.27)1.06 (0.30, 3.78)–
     $75,001+1.24 (0.54, 2.81)2.12 (0.56, 8.07)0.55 (0.12, 2.50)2.07 (0.10, 40.87)
    SES ladder1.07 (0.87, 1.33)1.01 (0.82, 1.26)1.00 (0.82, 1.24)0.63 (0.23, 1.67)
    Self-rated health good/very good/excellent4.77 (2.30, 9.88)1.59 (0.78, 3.26)5.23 (1.99, 13.74)12.75 (0.16, 1020.04)
    Interaction: Self-rated health *discrimination score0.88 (0.65, 1.17)0.97 (0.74, 1.26)0.31 (0.14, 0.72)0.79 (0.43, 1.42)
    80% or more publicly insured/uninsured1.25 (0.21, 7.41)1.24 (0.52, 2.95)0.32 (0.11, 0.95)0.84 (0.12, 5.80)
    Previously screened for social risks in prior 12 months1.38 (0.53, 3.53)1.28 (0.56, 2.92)0.77 (0.27, 2.19)0.21 (0.01, 4.54)
    Interaction: Previously screened* discrimination score1.36 (0.86, 2.15)1.03 (0.79, 1.35)4.65 (1.92, 11.29)1.49 (0.53, 4.24)
    Previously assisted with social risks in prior  12 months1.54 (0.47, 5.02)0.73 (0.35, 1.53)1.03 (0.27, 3.99)0.26 (0.01, 5.53)

    • Abbreviations: SES, socioeconomic status; CI, confidence interval.

  • Table 1.

    Adjusted Associations Between Complete Trust in Healthcare Provider and Variables of Interest (n = 690) (Sensitivity Analysis Using 1–9 vs 10 Cut Point)

    Adjusted Odds Ratio (95% CI)
    Healthcare discrimination score0.74 (0.60, 0.93)
    Race and ethnicity
     Non-Hispanic White (reference)
     Non-Hispanic Black0.80 (0.50, 1.23)
     Hispanic0.71 (0.44, 1.07)
     Non-Hispanic multiple/other0.61 (0.30, 1.13)
    Age
     18 to 44 (reference)
     45 to 641.34 (0.84, 2.17)
     65+1.27 (0.68, 2.42)
    Education 12 or more years0.40 (0.27, 0.63)
    Income
     $0–50k (reference)
     $50,001–75k1.08 (0.55, 2.28)
     $75,001+0.81 (0.47, 1.49)
    SES ladder1.06 (1.01, 1.11)
    Self-rated health good/very good/excellent1.73 (1.16, 2.55)
    Interaction: Self-rated health * discrimination score0.95 (0.80, 1.12)
    80% or more publicly insured/uninsured0.86 (0.57, 1.27)
    Previously screened for social risks in prior 12 months0.93 (0.57, 1.52)
    Interaction: Previously screened * discrimination score1.33 (1.02, 1.74)
    Previously assisted with social risks in prior 12 months0.91 (0.64, 1.29)

    • Abbreviations: SES, socioeconomic status; CI, confidence interval.

  • Table 2.

    Adjusted Associations Between Complete Trust in Healthcare Provider and Variables of Interest, Stratified by Race and Ethnicity (Sensitivity Analysis Using 1–9 vs 10 Cut Point)

    Adjusted Odds Ratio (95% CI)
    Non-Hispanic White (n = 275)Non-Hispanic Black (n = 161)Hispanic (n = 196)Non-Hispanic Multiple/Other (n = 55)
    Healthcare discrimination score0.69 (0.53, 0.88)0.70 (0.49, 1.01)0.73 (0.57, 0.93)0.49 (0.26, 0.93)
    Age
     18 to 44 (reference)
     45 to 641.50 (0.71, 3.18)1.77 (0.88, 3.58)0.55 (0.21, 1.44)6.95 (1.72, 28.06)
     65+1.43 (0.64, 3.18)1.60 (0.49, 5.30)1.00 (0.18, 5.57)--
    Education 12 or more years0.35 (0.09, 1.41)0.46 (0.21, 1.02)0.35 (0.18, 0.68)0.12 (0.02, 0.82)
    Income
     $0–50k (reference)
     $50,001–75k1.92 (0.58, 6.30)0.75 (0.29, 1.94)0.60 (0.18, 2.06)0.36 (0.03, 4.21)
     $75,001+0.95 (0.41, 2.23)0.67 (0.15, 3.03)0.30 (0.05, 1.93)0.30 (0.05, 1.86)
    SES ladder1.05 (0.91, 1.22)1.06 (0.96, 1.17)1.04 (0.94, 1.14)1.55 (0.89, 2.70)
    Self-rated health good/very good/excellent1.65 (1.02, 2.67)1.04 (0.32, 3.39)2.67 (1.44, 4.93)1.03 (0.30, 3.49)
    Interaction: Self-rated health * discrimination score1.01 (0.84, 1.21)1.17 (0.74, 1.85)0.57 (0.40, 0.81)0.87 (0.35, 2.12)
    80% or more publicly insured/uninsured0.91 (0.48, 1.73)0.86 (0.61, 1.20)0.86 (0.57, 1.57)0.61 (0.17, 2.20)
    Previously screened for social risks in prior 12 months0.98 (0.63, 1.53)0.92 (0.42, 2.03)0.60 (0.89, 1.95)3.21 (0.51, 20.41)
    Interaction: Previously screened * discrimination score1.65 (1.27, 2.13)1.09 (0.70, 1.71)1.92 (1.17, 3.15)1.49 (0.75, 2.98)
    Previously assisted with social risks in prior 12 months0.96 (0.32, 2.88)0.54 (0.36, 0.80)1.91 (0.63, 1.37)0.32 (0.05, 2.07)

    • Abbreviations: SES, socioeconomic status; CI, confidence interval.

  • Table 3.

    Adjusted Associations Between High Trust in Healthcare Provider and Variables of Interest (n = 690) (Sensitivity Analysis Using 1–8 vs 9–10 Cut Point)

    Adjusted Odds Ratio (95% CI)
    Healthcare discrimination score0.82 (0.69, 0.98)
    Race and ethnicity
     Non-Hispanic White (reference)
     Non-Hispanic Black0.80 (0.48, 1.34)
     Hispanic0.81 (0.49, 1.33)
     Non-Hispanic multiple/other1.02 (0.49, 2.09)
    Age
     18 to 44 (reference)
     45 to 641.33 (0.81, 2.18)
     65+1.52 (0.62, 3.72)
    Education 12 or more years0.51 (0.37, 0.71)
    Income
     $0–50k (reference)
     $50,001–75k1.36 (0.81, 2.28)
     $75,001+1.11 (0.55, 2.24)
    SES ladder1.02 (0.95, 1.10)
    Self-rated health good/very good/excellent1.98 (1.54, 2.55)
    Interaction: Self-rated health * discrimination score0.86 (0.74, 1.00)
    80% or more publicly insured/uninsured0.81 (0.50, 1.32)
    Previously screened for social risks in prior 12 months1.00 (0.57, 1.76)
    Interaction: Previously screened * discrimination score1.20 (0.93, 1.55)
    Previously assisted with social risks in prior 12 months1.09 (0.77, 1.55)

    • Abbreviations: SES, socioeconomic status; CI, confidence interval.

  • Table 4.

    Adjusted Associations Between High Trust in Healthcare Provider and Variables of Interest, Stratified by Race and Ethnicity (Sensitivity Analysis Using 1–8 vs 9–10 Cut Point)

    Adjusted Odds Ratio (95% CI)
    Non-Hispanic White (n = 275)Non-Hispanic Black (n = 161)Hispanic (n = 196)Non-Hispanic Multiple/Other (n = 58)
    Healthcare discrimination score0.82 (0.62, 1.08)0.71 (0.53, 0.96)0.66 (0.48, 0.89)0.73 (0.48, 1.12)
    Age
     18 to 44 (reference)
     45 to 641.53 (0.78, 3.02)1.28 (0.52, 3.14)0.49 (0.13, 1.78)7.43 (1.42, 38.94)
     65+1.62 (0.69, 3.82)1.28 (0.23, 7.20)1.93 (0.41, 9.01)2.19 (0.14, 34.67)
    Education 12 or more years0.22 (0.03, 1.73)0.94 (0.43, 2.06)0.30 (0.18, 0.48)0.23 (0.05, 1.02)
    Income
     $0–50k (reference)
     $50,001–75k1.45 (0.46, 4.57)1.25 (0.32, 4.85)1.81 (0.71, 4.64)0.91 (0.05, 15.84)
     $75,001+1.39 (1.52, 4.62)0.93 (0.17, 4.94)0.33 (0.02, 5.21)0.11 (0.01, 0.89)
    SES ladder1.00 (0.89, 1.14)1.03 (0.88, 1.21)1.03 (0.94, 1.13)1.08 (0.55, 2.10)
    Self-rated health good/very good/excellent2.65 (1.52, 4.62)0.77 (0.50, 1.20)2.72 (1.77, 4.19)4.38 (0.98, 19.55)
    Interaction: Self-rated health * discrimination score0.88 (0.69, 1.13)1.12 (0.88, 1.43)0.52 (0.24, 1.12)0.80 (0.47, 1.35)
    80% or more publicly insured/uninsured0.65 (0.37, 1.13)0.83 (0.56, 1.23)1.04 (0.44, 2.46)0.23 (0.08, 0.65)
    Previously screened for social risks in prior 12 months0.98 (0.54, 1.78)1.16 (0.43, 3.10)0.88 (0.31, 2.51)0.36 (0.03, 4.59)
    Interaction: Previously screened * discrimination score1.45 (1.02, 2.05)1.04 (0.73, 1.48)1.96 (0.88, 4.35)1.25 (0.61, 2.54)
    Previously assisted with social risks in prior 12 months0.95 (0.34, 2.63)0.84 (0.34, 2.09)2.02 (0.43, 9.56)0.64 (0.08, 5.33)

    • Abbreviations: SES, socioeconomic status; CI, confidence interval.

  • Table 5.

    Adjusted Associations Between High Trust in Healthcare Provider and Variables of Interest (n = 690) (Sensitivity Analysis Using 1–7 vs 8–9 vs 10 Cut Point)

    Adjusted Odds Ratio (95% CI)
    Healthcare discrimination score0.73 (0.63, 0.85)
    Race and ethnicity
     Non-Hispanic White (reference)
     Non-Hispanic Black0.72 (0.45, 1.16)
     Hispanic0.67 (0.43, 1.06)
     Non-Hispanic multiple/other0.73 (0.40, 1.33)
    Age
     18 to 44 (reference)
     45 to 641.30 (0.87, 1.92)
     65+1.16 (0.61, 2.21)
    Education 12 or more years0.41 (0.28, 0.61)
     Income
     $0–50k (reference)
     $50,001–75k1.29 (0.72, 2.30)
     $75,001+0.93 (0.55, 1.56)
    SES ladder1.05 (0.98, 1.11)
    Self-rated health good/very good/excellent2.05 (1.40, 2.99)
    Interaction: Self-rated health * discrimination score0.92 (0.81, 1.05)
    80% or more publicly insured/uninsured0.83 (0.62, 1.10)
    Previously screened for social risks in prior 12 months0.93 (0.61, 1.42)
    Interaction: Previously screened * discrimination score1.33 (1.01, 1.74)
    Previously assisted with social risks in prior 12 months0.88 (0.63, 1.24)

    • Abbreviations: SES, socioeconomic status; CI, confidence interval.

  • Table 6.

    Adjusted Associations Between High Trust in Healthcare Provider and Variables of Interest, Stratified by Race and Ethnicity (Sensitivity Analysis Using 1–7 vs 8–9 vs 10 Cut Point)

    Adjusted Odds Ratio (95% CI)
    Non-Hispanic White (n = 275)Non-Hispanic Black (n = 161)Hispanic (n = 196)Non-Hispanic Multiple/Other (n = 58)
    Healthcare discrimination score0.73 (0.59, 0.90)0.68 (0.50, 0.92)0.58 (0.45, 0.76)0.71 (0.55, 0.91)
    Age
     18 to 44 (reference)
     45 to 641.38 (0.68, 2.77)1.58 (0.80, 3.15)0.62 (0.24, 1.63)3.93 (1.03, 14.99)
     65+1.35 (0.67, 2.74)1.42 (0.31, 6.54)0.90 (0.20, 3.94)0.35 (0.09, 1.34)
    Education 12 or more years0.37 (0.08, 1.73)0.69 (0.30, 1.60)0.30 (0.16, 0.56)0.26 (0.02, 2.78)
    Income
     $0–50k (reference)
     $50,001–75k2.01 (0.70, 5.81)1.06 (0.52, 2.20)0.86 (0.39, 1.91)0.93 (0.17, 5.04)
     $75,001+1.01 (0.46, 2.20)0.95 (0.27, 3.43)0.42 (0.10, 1.67)0.74 (0.18, 2.96)
    SES ladder1.05 (0.92, 1.20)1.04 (0.92, 1.18)1.02 (0.92, 1.12)1.20 (0.76, 1.88)
    Self-rated health good/very good/excellent2.27 (1.34, 3.84)1.16 (0.48, 2.80)3.08 (1.55, 6.10)1.46 (0.27, 7.98)
    Interaction: Self-rated health * discrimination score1.01 (0.84, 1.21)1.10 (0.78, 1.54)0.53 (0.32, 0.86)0.87 (0.46, 1.66)
    80% or more publicly insured/uninsured0.95 (0.46, 1.97)1.01 (0.67, 1.52)0.65 (0.33, 1.28)0.63 (0.19, 2.10)
    Previously screened for social risks in prior 12 months1.03 (0.62, 1.69)0.97 (0.53, 1.77)0.57 (0.22, 1.53)1.85 (0.36, 9.53)
    Interaction: Previously screened * discrimination score1.56 (1.15, 2.10)1.09 (0.72, 1.65)2.61 (1.47, 4.62)1.05 (0.60, 1.85)
    Previously assisted with social risks in prior 12 months1.08 (0.37, 3.17)0.61 (0.36, 1.04)1.73 (0.56, 5.33)0.37 (0.06, 2.30)

    • Abbreviations: SES, socioeconomic status; CI, confidence interval.

  • Table 7.

    Adjusted Associations Between High Trust in Healthcare Provider and Variables of Interest, Stratified by Participant Type (Original 1–7 vs 8–10 Cut Point)

    Adjusted Odds Ratio (95% CI)
    Adult Patients (n = 516)Pediatric Caregivers (n = 163)
    Healthcare discrimination score0.69 (0.57, 0.83)1.16 (0.80, 1.67)
    Race and ethnicity
     Non-Hispanic White (reference)
     Non-Hispanic Black0.50 (0.22, 1.15)0.40 (0.32, 0.50)
     Hispanic0.81 (0.33, 1.99)0.22 (0.53, 0.92)
     Non-Hispanic multiple/other1.38 (0.47, 4.03)0.06 (0.01, 0.32)
    Age
     18 to 44 (reference)
     45 to 641.31 (0.86, 2.01)1.00 (--)
     65+1.21 (0.46, 3.21)—
    Education 12 or more years0.68 (0.34, 1.36)0.24 (0.13, 0.43)
    Income
     $0–50k (reference)
     $50,001–75k2.44 (0.83, 7.17)1.02 (0.11, 9.38)
     $75,001+1.42 (0.81, 2.50)2.70 (0.85, 8.54)
    SES ladder0.98 (0.87, 1.11)1.32 (1.25, 1.40)
    Self-rated health good/very good/excellent3.32 (2.13, 5.16)3.18 (0.75, 13.44)
    Interaction: Self-rated health * discrimination score0.83 (0.67, 1.04)0.69 (0.50, 0.95)
    80% or more publicly insured/uninsured0.75 (0.41, 1.36)1.16 (0.52, 2.58)
    Previously screened for social risks in prior 12 months0.98 (0.52, 1.84)1.04 (0.51, 2.09)
    Interaction: Previously screened * discrimination score1.40 (1.05, 1.88)0.96 (0.79, 1.17)
    Previously assisted with social risks in prior 12 months0.91 (0.57, 1.45)0.89 (0.39, 1.99)

    • Abbreviations: SES, socioeconomic status; CI, confidence interval.

  • Table 8.

    Adjusted Associations Between High Trust in Healthcare Provider and Variables of Interest, Stratified by Healthcare Setting (Original 1–7 vs 8–10 Cut Point)

    Adjusted Odds Ratio (95% CI)
    Primary Care (n = 410)Emergency Department (n = 280)
    Healthcare discrimination score0.64 (0.46, 0.89)0.82 (0.67, 0.99)
    Race and ethnicity
     Non-Hispanic White (reference)
     Non-Hispanic Black0.48 (0.9, 1.27)0.73 (0.19, 2.77)
     Hispanic0.57 (0.23, 1.42)0.69 (0.10, 4.86)
     Non-Hispanic multiple/other1.31 (0.35, 4.98)0.64 (0.09, 4.29)
    Age
     18 to 44 (reference)
     45 to 640.89 (0.62, 1.27)3.67 (1.69, 7.98)
     65+0.83 (0.22, 3.17)1.91 (0.54, 6.86)
     Education 12 or more years0.38 (0.29, 0.50)0.93 (0.24, 3.55)
    Income
     $0–50k (reference)
     $50,001–75k2.94 (0.62, 13.92)1.45 (0.37, 5.61)
     $75,001+1.80 (0.94, 3.43)1.06 (0.57, 1.97)
    SES ladder0.94 (0.82, 1.08)1.17 (1.05, 1.30)
    Self-rated health good/very good/excellent3.21 (2.04, 5.06)3.36 (1.19, 9.51)
    Interaction: Self-rated health * discrimination score0.80 (0.59, 1.08)0.96 (0.77, 1.21)
    80% or more publicly insured/uninsured0.83 (0.50, 1.38)0.75 (0.34, 1.65)
    Previously screened for social risks in prior 12 months1.18 (0.56, 2.50)0.71 (0.64, 0.79)
    Interaction: Previously screened * discrimination score1.59 (1.12, 2.26)1.03 (0.87, 1.21)
    Previously assisted with social risks in prior 12 months0.95 (0.55, 1.66)0.92 (0.64, 1.34)

    • Abbreviations: SES, socioeconomic status; CI, confidence interval.

  • Table 9.

    Characteristics of Disaggregated Hispanic Participants

    n (%)
    TotalMexican, Mexican American, Chicano (n = 137)Puerto Rican (n = 42)Other Hispanic, Latino, or Spanish Origin (n = 150)
    Biological sex
     Female242 (74)103 (75)30 (71)109 (73)
    Age
     18 to 44220 (68)90 (67)28 (67)102 (69)
     45 to 6480 (25)38 (28)11 (26)31 (21)
     65+26 (8)7 (5)3 (7)16 (11)
    Years of education
     12 or more years204 (62)82 (60)34 (81)87 (59)
    Income
     $0–50k228 (89)109 (96)27 (75)92 (86)
     $50,001–75k15 (6)1 (1)7 (19)7 (7)
     $75,001+14 (5)4 (4)2 (6)8 (8)
    SES ladder position*5.15 (2.28)5.30 (2.12)5.71 (2.05)4.88 (2.45)
    Healthcare setting
     Primary care209 (64)111 (81)10 (24)88 (59)
    Clinic type
     Urban academic196 (60)53 (39)40 (95)103 (69)
     Urban non-academic58 (18)37 (27)1 (2)20 (13)
     Non-urban non-academic75 (23)47 (34)1 (2)27 (18)
    Percentage publicly insured/uninsured at site
     80% or more publicly insured/uninsured159 (48)68 (50)13 (31)78 (52)
    Participant type
     Adult patient275 (84)124 (91)29 (69)122 (81)
    Preferred language
     Spanish169 (51)76 (56)7 (17)86 (57)
    Patient/caregiver-reported health
     Good, Very good, excellent231 (74)90 (68)27 (66)114 (81)
    Experienced any of 7 categories perceived discrimination75 (23)27 (20)13 (31)35 (23)
    Healthcare discrimination score*0.55 (1.31)0.54 (1.36)1 (1.80)0.43 (1.05)
    Asked about needs in any domains in the past 12 months81 (26)39 (30)10 (24)32 (22)
    Assisted with needs in any domains in the past 12 months58 (18)20 (15)7 (17)31 (22)

    • *mean (S.D.).

    • Abbreviation: SES, socioeconomic status.

  • Table 10.

    Trust in Healthcare Provider and Experiences of Healthcare Discrimination Among Disaggregated Hispanic Participants

    n (%)
    TotalMexican, Mexican American, Chicano (n = 137)Puerto Rican (n = 42)Other Hispanic, Latino, or Spanish Origin (n = 150)
    Low/medium trust (1 to 7)70 (23)27 (21)13 (32)30 (21)
    High trust (8 to 10)240 (77)104 (80)28 (68)108 (78)
    Experienced any of 7 categories perceived discrimination75 (23)27 (20)13 (31)35 (23)
    Item 1: Felt like a doctor or nurse was not listening to what you were saying59 (18)23 (17)11 (26)25 (17)
    Item 2: Treated you with less respect than other people28 (9)12 (9)7 (17)9 (6)
    Item 3: Received poorer services than other people20 (6)8 (6)6 (14)6 (4)
    Item 4: Treated with less courtesy than other people29 (9)12 (9)7 (17)10 (7)
    Item 5: Had a doctor or nurse act as if he or she was better than you21 (7)8 (6)5 (12)8 (5)
    Item 6: Had a doctor or nurse act as if he or she thinks you were not smart24 (7)9 (7)5 (12)10 (7)
    Item 7: Had a doctor or nurse act as if he or she was afraid of you3 (1)2 (2)0 (0)1 (1)
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