Factors affecting trust in healthcare among middle-aged to older Korean American women

Background: Predictors of trust in healthcare providers and the healthcare system have never been studied in Korean Americans (KA) despite the fact that trust plays an important role in health behaviors. The purpose of this study is to examine factors influencing trust in the healthcare system and providers among KA women. Methods: Data were collected in 196 KA women examining the effects of perceived discrimination and trust on breast cancer screening in the Chicago metropolitan area. Path analysis was used to identify factors influencing trust in the healthcare system and providers. Results: Acculturation was positively related to trust in healthcare providers (beta = .15, p =. 002), and discrimination in the healthcare system was inversely related to trust in healthcare providers (beta = -.60, p < .001). Length of stay in the US was inversely related to distrust in the healthcare system (beta = -.14, p < .001), and discrimination in healthcare was positively related to distrust in the healthcare system (ss = .60, p < .001). Trust in healthcare providers and distrust in the healthcare system were moderately correlated (r = .51, p < .001). Conclusion: Higher levels of acculturation and lower levels of perceived discrimination were identified as predictors of higher levels of trust in healthcare providers. A shorter stay in the US and higher levels of discrimination were identified as predictors of higher levels of distrust in the healthcare system. Perceived discrimination is a target for interventions to enhance trust in the healthcare system, and therefore reduce healthcare disparities in KAs.