Disparities/Minority Health

Trust in medical care does not differ by race among indigent people with diabetes, but more trust can improve their quality of life

Distrust in the medical care system has been suggested as a source of blacks' higher morbidity and mortality from diabetes when compared with whites. However, a new study found that trust in the medical care system did not appear to differ significantly by race or ethnicity among indigent patients with type 2 diabetes. Medical mistrust was not significantly correlated with glycemic control, lipid control, or other health outcomes; however, less distrustful patients felt more in control of their diabetes and reported better physical and mental health.

It may be that distrust of the medical care system is not as important a contributor to health disparities in diabetes as it is in other disease conditions, something that would have to be confirmed in larger studies. On the other hand, strategies to build trust in the patient-provider relationship and between patients and the health care system may help improve the quality of life of patients with type 2 diabetes, conclude Medical University of South Carolina researchers, Leonard E. Egede, M.D., M.S., and Yvonne Michel, Ph.D.

Drs. Egede and Michel analyzed survey responses of 216 people with type 2 diabetes recruited from an indigent clinic of an academic medical center. The surveys included the 15-item Medical Mistrust Index, the 23-item Diabetes Knowledge Test, the 15-item Perceived Control (of diabetes) Questionnaire, and a 12-item health status survey. The researchers abstracted patients' lipid levels, glucose levels, and other health measures from their medical records. Their study was supported by the Agency for Healthcare Research and Quality (HS11418).

See "Medical mistrust, diabetes, self-management, and glycemic control in an indigent population with type 2 diabetes," by Drs. Egede and Michel, in the January 2006 Diabetes Care 29(1), pp. 131-132.

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