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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2005.080762v1 97/7/1283    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (10) Citing Articles via Google Scholar Google Scholar Articles by Armstrong, K. Articles by Putt, M. Search for Related Content PubMed PubMed Citation Articles by Armstrong, K. Articles by Putt, M. Related Collections Epidemiology Geography Other Health Service Delivery African Americans/Blacks Hispanics/Latinos

Katrina Armstrong, MD, MSCE, Karima L. Ravenell, MS, Suzanne McMurphy, PhD and Mary Putt, ScD

At the time of the study, Katrina Armstrong, Karima L. Ravenell, and Suzanne McMurphy were with the Department of Medicine and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia. Mary Putt and Katrina Armstrong were with the Department of Biostatistics and Epidemiology, University of Pennsylvania, Phialdelphia.

Correspondence: Requests for reprints should be sent to Dr Katrina Armstrong, Department of Medicine, University of Pennsylvania, 1204 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104 (e-mail: karmstro{at}mail.med.upenn.edu).

Objectives. We examined the racial/ethnic and geographic variation in distrust of physicians in the United States.

Methods. We obtained data from the Community Tracking Study, analyzing 20 sites where at least 5% of the population was Hispanic and 5% was Black.

Results. In univariate analyses, Blacks and Hispanics reported higher levels of physician distrust than did Whites. Multivariate analyses, however, suggested a complex interaction among sociodemographic variables, city of residence, race/ethnicity, and distrust of physician. In general, lower socioeconomic status (defined as lower income, lower education, and no health insurance) was associated with higher levels of distrust, with men generally reporting more distrust than women. But the strength of these effects was modified by race/ethnicity. We present examples of individual cities in which Blacks reported consistently higher mean levels of distrust than did Whites, consistently lower mean levels of distrust than did Whites, or a mixed relationship dependent on socioeconomic status. In the same cities, Hispanics reported either consistently higher mean levels of distrust relative to Whites or a mixed relationship.

Conclusions. Racial/ethnic differences in physician distrust are less uniform than previously hypothesized, with substantial geographic and individual variation present.

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