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Medical Mistrust in Black Breast Cancer Patients: Acknowledging the Roles of the Trustor and the Trustee

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Abstract

Studies indicate that Black patients report higher medical mistrust compared to their White counterparts. However, little is known about factors associated with higher medical mistrust among Black breast cancer patients. We examined predictors of medical mistrust and relationships between medical mistrust, subscales of mistrust, and process of care factors to identify opportunities to promote positive healthcare interactions between the trustees (e.g., providers) and Black breast cancer patients, or the trustors. A secondary analysis was conducted of survey data from 210 Black women with confirmed diagnosis of invasive breast cancer. Participants completed telephone surveys consisting of questions pertaining to sociodemographics, attitudes, and beliefs about medical care and breast cancer treatments. Multiple linear regression determined factors associated with medical mistrust and mistrust subscales. Most participants (61%) were over the age of 50 and currently single (64.8%). Women with greater medical mistrust reported less satisfaction with the trustee’s technical ability (p < 0.0001) and greater satisfaction with their own propensity to access care (p < 0.05). Additionally, women with public insurance demonstrated greater mistrust (p < 0.01) and suspicion (p < 0.05) than women with private insurance, and women with less education reported greater perceived discrimination than women who have at least a bachelor’s degree. Findings from this study may inform future endeavors to educate providers on ways to effectively interact with and treat Black breast cancer patients. Opportunities to develop interventions that address and tackle issues of mistrust as reported by Black patients may contribute to ongoing efforts to reduce health disparities.

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Acknowledgements

We would like to thank the women who agreed to participate in this study. Funding for this work was supported in part by the American Cancer Society (MRSGT-06-132-01 CPPB) and Virginia Commonwealth University Massey Cancer Center Shared Resource, supported, in part, with funding from NIH-NCI Cancer Center Support Grant P30 CA016059.

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Authors and Affiliations

  1. Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, 830 East Main Street, 9th Floor, Suite 919, Richmond, VA, 23219, USA

    Arnethea L. Sutton, Jun He, Megan C. Edmonds & Vanessa B. Sheppard

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  1. Arnethea L. Sutton
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  2. Jun He
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Correspondence to Arnethea L. Sutton.

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All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable standards.

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Informed consent was obtained from all individual participants included in the study.

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Sutton, A.L., He, J., Edmonds, M.C. et al. Medical Mistrust in Black Breast Cancer Patients: Acknowledging the Roles of the Trustor and the Trustee. J Canc Educ 34, 600–607 (2019). https://doi.org/10.1007/s13187-018-1347-3

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