Does Trust Mediate the Relationship Between Experiences of Discrimination and Health Care Access and Utilization Among Minoritized Canadians During COVID-19 Pandemic?

IF 3.2 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Joseph Kangmennaang, Alhassan Siiba, Elijah Bisung
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引用次数: 0

Abstract

Objectives: We sought to determine if trust in government institutions mediate the relationship between experiences of discrimination and health care utilization during the COVID-19 pandemic.

Methods: We used data from Statistics Canada's Crowdsourcing Data: Impacts of COVID-19 on Canadians-Experiences of Discrimination. We used generalized linear latent and mixed models (Gllamm) with a binomial and logit link function as well as generalized structural equation modeling (GSEM) to determine if reported discrimination and trust were associated with difficulties in accessing health services, health care, and the likelihood of experiencing negative health impacts. We also examined if trust mediated the relationship between experiences of discrimination and these health outcomes. Our analytical sample consisted of 2568 individuals who self-identified as belonging to a visible minority group.

Results: The multivariate results indicate that experiences of discrimination during COVID-19 were associated with higher odds of reporting difficulties in accessing general health services (OR = 1.99, p ≤ 0.01), receiving care (OR = 1.65, p ≤ 0.01), and higher likelihood of reporting negative health impacts (OR = 1.68, p ≤ 0.01). Our mediation analysis indicated that trust in public institutions explained a substantial portion of the association between reported discrimination and all the health outcomes, although the effects of experiencing discrimination remain significant and robust.

Conclusion: The findings show that building and maintaining trust is important and critical in a pandemic recovery world to build back better.

在新冠肺炎大流行期间,信任是否介导了未成年加拿大人的歧视经历与获得和利用医疗保健之间的关系?
目标:我们试图确定在新冠肺炎大流行期间,对政府机构的信任是否在歧视经历和医疗保健利用之间起到了中介作用。方法:我们使用加拿大统计局的众包数据:新冠肺炎对加拿大人歧视经历的影响。我们使用具有二项式和logit链接函数的广义线性潜在和混合模型(Gllamm)以及广义结构方程模型(GSEM)来确定所报告的歧视和信任是否与获得医疗服务、医疗保健的困难以及经历负面健康影响的可能性有关。我们还研究了信任是否介导了歧视经历与这些健康结果之间的关系。我们的分析样本由2568人组成,他们自称属于明显的少数群体。结果:多变量结果表明,新冠肺炎期间的歧视经历与报告获得一般医疗服务困难的可能性较高(OR = 1.99,p ≤ 0.01),接受护理(OR = 1.65,p ≤ 0.01),报告负面健康影响的可能性更高(OR = 1.68,p ≤ 0.01)。我们的调解分析表明,对公共机构的信任在很大程度上解释了报告的歧视与所有健康结果之间的联系,尽管经历歧视的影响仍然显著而强烈。结论:研究结果表明,在疫情复苏的世界里,建立和保持信任对于重建得更好至关重要。
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来源期刊
Journal of Racial and Ethnic Health Disparities
Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
7.30
自引率
5.10%
发文量
263
期刊介绍: Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.
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