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BMC Public Health
Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | COVID-19 Vaccination | Research

Racial/ethnic differences in the associations between trust in the U.S. healthcare system and willingness to test for and vaccinate against COVID-19

Authors: Judy Nanaw, Juliana S. Sherchan, Jessica R. Fernandez, Paula D. Strassle, Wizdom Powell, Allana T. Forde

Published in: BMC Public Health | Issue 1/2024

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Abstract

Background

Trust in the healthcare system may impact adherence to recommended healthcare practices, including willingness to test for and vaccinate against COVID-19. This study examined racial/ethnic differences in the associations between trust in the U.S. healthcare system and willingness to test for and vaccinate against COVID-19 during the first year of the pandemic.

Methods

This cross-sectional study used data from the REACH-US study, a nationally representative online survey conducted among a diverse sample of U.S. adults from January 26, 2021-March 3, 2021 (N = 5,121). Multivariable logistic regression estimated the associations between trust in the U.S. healthcare system (measured as “Always”, “Most of the time”, “Sometimes/Almost Never”, and “Never”) and willingness to test for COVID-19, and willingness to receive the COVID-19 vaccine. Racial/ethnic differences in these associations were examined using interaction terms and multigroup analyses.

Results

Always trusting the U.S. healthcare system was highest among Hispanic/Latino Spanish Language Preference (24.9%) and Asian (16.7%) adults and lowest among Multiracial (8.7%) and Black/African American (10.7%) adults. Always trusting the U.S. healthcare system, compared to never, was associated with greater willingness to test for COVID-19 (AOR: 3.20, 95% CI: 2.38–4.30) and greater willingness to receive the COVID-19 vaccine (AOR: 2.68, 95% CI: 1.97–3.65).

Conclusions

Trust in the U.S. healthcare system was associated with greater willingness to test for COVID-19 and receive the COVID-19 vaccine, however, trust in the U.S. healthcare system was lower among most marginalized racial/ethnic groups. Efforts to establish a more equitable healthcare system that increases trust may encourage COVID-19 preventive behaviors.
Appendix
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Metadata
Title
Racial/ethnic differences in the associations between trust in the U.S. healthcare system and willingness to test for and vaccinate against COVID-19
Authors
Judy Nanaw
Juliana S. Sherchan
Jessica R. Fernandez
Paula D. Strassle
Wizdom Powell
Allana T. Forde
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-18526-6

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