ASPO Abstracts
Medical Mistrust and COVID-19
Category: COVID-19 and Cancer
Conference Year: 2021
Abstract Body:
Purpose: The COVID-19 pandemic has highlighted feelings of medical mistrust, particularly with
regard to healthcare disparities and healthcare utilization. This study examined medical mistrust
amongst some of the most vulnerable groups, such as cancer survivors, and identified correlates
of medical mistrust.
Methods: We developed a survey to understand the impact of the COVID-19 pandemic on cancer
survivors' ability to access care and medical information, identify problems with meeting daily
needs, and their perceptions of healthcare and of the government. The survey was disseminated,
via Qualtrics, to cancer survivors and to individuals without cancer who served as a control group.
For this analysis, medical mistrust, measured using the group-based medical mistrust scale, was
the outcome. Covariates of interest included demographic factors (e.g. race/ethnicity), cancer
status (yes/no; type), and trust in government. T-test was used to assess bivariate associations
between covariates and medical mistrust by cancer status. Multiple regression was used to assess
multivariate associations amongst all individuals and cancer patients only.
Results: Of the 939 respondents, 624 (66.5%) had cancer. Most respondents were White (66.6%),
> 41 years old (56.8%), and had at least a Bachelor's degree (49.73%). Compared to individuals
without cancer, individuals with cancer were older (p=0.002); White (p<0.0001), and reported lower
medical mistrust (p=0.016). In multivariate analysis, individuals who were 18-40 years old (vs. > 41
years old) (OR: 4.79, 95%, CI: 2.07 – 11.11; p=0.0003) and individuals with Hispanic or Latinx (vs.
non-Hispanic) (OR: 3.72, 95%, CI: 1.17 – 11.178; p=0.026). Amongst individuals with cancer,
younger age and Stages II and IV (vs. Stage I) were related to higher mistrust. Compared to White
individuals with cancer, Black individuals were 6 times more likely (p=0.042) and Hispanic
individuals were 9 times more likely (p=0.015) to report higher mistrust.
Conclusions: Medical mistrust is high for younger individuals and amongst people of color. As the
Hispanic and Black populations have suffered from disparities in outcomes as a result of COVID-
19 and cancer, efforts to address mistrust in these populations are warranted.
Keywords: Medical Mistrust, Cancer survivors