Laura is the editorial director of The American Journal of Managed Care® (AJMC®) and all its brands, including The American Journal of Accountable Care®, Evidence-Based Oncology™, and The Center for Biosimilars®. She has been working on AJMC® since 2014 and has been with AJMC®'s parent company, MJH Life Sciences, since 2011. She has an MA in business and economic reporting from New York University.
Mistrust in healthcare can have big repercussions and can perpetuate ongoing health disparities. Here are 5 things about medical mistrust.
Caring for patients and building an efficient healthcare system relies on trust between providers and patients. However, historical events, current biases, and perceptions of stigma can all stand in the way of patients seeking the care they need or being properly treated when they do seek care. Mistrust in healthcare can have big repercussions and can perpetuate ongoing health disparities.
Here are 5 things about medical mistrust.
1. Historical events fuel current mistrust
The most commonly identified study in the past that has engendered mistrust is the Tuskegee Syphilis Study, which began in 1932 and went on for 40 years. The study involved 600 black men, 399 who had syphilis and 201 who did not. The participants were not treated properly, even after penicillin became the standard of care, and later investigators showed that there was no evidence that the researchers had informed the participants of the study or its real purpose.
While the last participant has since passed away, there are 12 offspring who are still alive, and the repercussions continue with some minority patients still avoiding research.
2. Minority patients might miss out on advances in care
A lack of diversity in genomic research can limit the understanding of population-specific differences in disease risk. In addition, underserved racial and ethnic groups may have difficulty accessing precision medicines that can provide improved outcomes.
Research published in March 2019 revealed a lack of diversity among cell lines used for laboratory studies for prostate, breast, and cervical cancer. This lack of diversity prevents the health equity gap from narrowing.
3. Mistrust and past experiences delay routine care
A new study from the Health Disparities Institute at UConn Health showed that medical mistrust causes black men to delay preventive care. That mistrust is rooted in personal experiences with prejudice and discrimination.
The authors noted that black men are more likely to have high blood pressure, which would be caught early during routine health screenings. When high blood pressure and other conditions, like high cholesterol, are not caught early, they increase the risk of heart and stroke dramatically.
4. Biases can lead to populations mistrusting healthcare providers
At the 2018 National Committee for Quality Assurance’s Quality Talks meeting, Toyin Ajayi, MD, MPhil, chief health officer and founder of Cityblock Health, noted that patients who are part of a minority, have a disability, or who are a member of the LGBTQ community know they can face biases that result in a lack of care.
In just 2016, research showed that black patients were undertreated for pain compared with white patients. Other misconceptions that may cause healthcare providers to treat black patients differently than white patients, further fueling feelings of mistrust, are that black people have thicker skin or heal more quickly.
5. Work has to be done to actively win back trust
In 2017, ReviveHealth released the results of a survey that showed trust in healthcare had hit the lowest level in more than a decade.
The ABIM Foundation has acknowledged the issue of trust in healthcare with its Trust Practice Challenge, which is identifying practices that build or rebuild trust in healthcare. ABIM Foundation was looking for organizations that regularly practiced building trust through various initiatives. In May, 8 winners were announced.