Explorations of Black Health in America: The Effects of Trust on Health Care Utilization between U.S.-Born Black Americans and Black Foreign-Born African Immigrants
Abstract
Historically, those that identify with the African diaspora have had a complicated
and understudied relationship with the United States medical system. Available literature
makes generalizations related to different populations across the African diaspora
because they are all labeled under the “black” racial group. Consequently, this qualitative
study investigated the impact of trust on health care utilization between black foreign-born
African immigrants, including first and second-generation immigrants, compared to
black Americans born in the United States. There were six U.S.-born black American
participants and five black foreign-born African immigrants, resulting in a total
of eleven in-depth interviews. When evaluating the role of trust in using resources
within the healthcare system across both study populations, there seemed to be no
clear conclusion on its impact. Some participants considered trust as one of their
top three factors influencing how they utilized health care resources, while others
indicated that it was not important to them at all. Some participants also noted that
trust interacted with their personal identifiers – such as gender, race, and socioeconomic
status – and their health care utilization. Additionally, the study revealed a high
level of trust in individual providers but not the healthcare system as an institution
for U.S.-born black Americans. On the other hand, black foreign-born African immigrants
from West Africa had a significantly higher level of trust in the United States healthcare
system compared to those from the Central, Eastern, and Southern regions of Africa.
While there is variability in trust between the sample populations, participants mentioned
that their level of trust in the United States healthcare system and their usage of
resources would increase if there was more staff diversity, improvements in cultural
competency surrounding different medical practices, and greater accessibility to quality
care, especially in low-income communities.
Type
Honors thesisDepartment
SociologySubject
Health care utilizationBlack Americans
African immigrant
Trust
United States healthcare system
Qualitative study
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https://hdl.handle.net/10161/24921Citation
Ezem, Natalie (2022). Explorations of Black Health in America: The Effects of Trust on Health Care Utilization
between U.S.-Born Black Americans and Black Foreign-Born African Immigrants. Honors thesis, Duke University. Retrieved from https://hdl.handle.net/10161/24921.Collections
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