Medical mistrust and less satisfaction with health care among Native Americans presenting for cancer treatment

J Health Care Poor Underserved. 2009 Feb;20(1):210-26. doi: 10.1353/hpu.0.0108.


Purpose: To assess barriers to cancer care among Native Americans, whose health outcomes compare unfavorably with those of the general U.S. population.

Methods and patients: We undertook a comparative community-based participatory research project in which newly-diagnosed cancer patients were prospectively surveyed using novel scales for medical mistrust and satisfaction with health care. Socio-demographic information was obtained. Mean scale scores for mistrust and satisfaction were analyzed by race. Multivariable models were used to adjust for income, education level, and distance lived from cancer care institute.

Results: Participation refusal rate was 38%. Of 165 eligible patients, 52 were Native American and 113 where non-Hispanic White. Native Americans expressed significantly higher levels of mistrust (p=0001) and lower levels of satisfaction (p=.0001) with health care than Whites. In multivariable analyses, race was the only factor found to be significantly predictive of higher mistrust and lower satisfaction scores.

Conclusion: Native Americans exhibit higher medical mistrust and lower satisfaction with health care.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Health Services / statistics & numerical data
  • Healthcare Disparities
  • Humans
  • Indians, North American / psychology*
  • Male
  • Middle Aged
  • Neoplasms / ethnology*
  • Neoplasms / psychology*
  • Patient Acceptance of Health Care / ethnology
  • Patient Satisfaction / ethnology*
  • Prospective Studies
  • Socioeconomic Factors
  • Trust*