Attitudes about racism, medical mistrust, and satisfaction with care among African American and white cardiac patients.

The authors examine determinants of satisfaction with medical care among 1,784 (781 African American and 1,003 white) cardiac patients. Patient satisfaction was modeled as a function of predisposing factors (gender, age, medical mistrust, and perception of racism) and enabling factors (medical insurance). African Americans reported less satisfaction with care. Although both black and white patients tended not to endorse the existence of racism in the medical care system, African American patients were more likely to perceive racism. African American patients were significantly more likely to report mistrust. Multivariate analysis found that the perception of racism and mistrust of the medical care system led to less satisfaction with care. When perceived racism and medical mistrust were controlled, race was no longer a significant predictor of satisfaction.

Racial differences in attitudes toward professional mental health care and in the use of services.

Differences in attitudes toward seeking professional mental health care and in the utilization of mental health services were examined by analyzing the second part of the National Comorbidity Survey. Prior to use of services, African Americans were found to have more positive attitudes than whites toward seeking such services, but less likely to use them. After utilization, their attitudes were found to be less positive than those of whites.

Extreme social isolation, use of community-based senior support services, and mortality among African American elderly women.

The effect of extreme social isolation and use of community-based senior services on longevity was examined in a national sample of African American elderly women (ages 55-96). Consistent with previous research on the social integration/mortality link, African American elderly women who were extremely socially isolated were hypothesized to have a higher 5-year mortality rate. It was also hypothesized that use of community senior services would be negatively associated with 5-year mortality. Results of logistic regression analysis controlling for age, education, income, and health status found that extremely socially isolated African American elderly women were three times more likely than the nonisolated women to die within the 5-year period from the initial survey. Use of community senior services did not have a relationship on mortality. Results are discussed in terms of directions for future research and intervention.