Date

7-21-2026

Department

School of Health Sciences

Degree

Doctor of Philosophy in Health Sciences (PhD)

Chair

Sheila Blanche Davis

Keywords

Medical mistrust, racial bias, implicit bias, healthcare disparities, racial concordance, healthcare utilization, cross-sectional study

Disciplines

Medicine and Health Sciences

Abstract

The purpose of this quantitative, non-experimental, cross-sectional group comparison was to examine whether differences exist in levels of medical mistrust, healthcare avoidance, and preference for racially concordant providers between young Black adults and young White adults residing in Texas. An electronic, pilot-tested survey was distributed via social media and included demographic items and Likert-scale measures to assess trust levels and healthcare decision-making behaviors. Independent samples t-tests were conducted using IBM SPSS software to compare group means. Results indicated statistically significant differences across all three variables. Young Black adults reported significantly higher levels of medical mistrust (lower scores indicating greater mistrust; M = 11.95, SD = 4.43) than young White adults (M = 15.52, SD = 3.17), t(111.76) = -5.250, p < .001, d = 0.93. Black respondents were more likely to report avoiding or delaying care (M = 2.40, SD = 1.43) than White respondents (M = 3.57, SD = 1.08), t(114.92) = -5.24, p < .001, d = 0.93, and displayed stronger preferences for racially concordant providers (M = 2.56, SD = 1.16) than White participants (M = 4.07, SD = 0.86), t(113.86) = -8.44, p < .001, d = 1.49. The findings suggest that racial disparities in healthcare are associated with measurable differences in healthcare perceptions and utilization behavior among young adults in Texas. This study contributes quantitative evidence regarding differences in medical mistrust along racial lines and informs future research examining structural and psychosocial influences on healthcare decision-making.

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