The AC Phoenix
Decemher 2007
Page 5
ETHNIC BACKGROUND
INFLUENCES USE
OF MEDICAL
INFORMATION
Durham, NC — Race and ethnic background are known to play a role
in how people get medical information, but new research from Duke
Medical Center sheds important light on another factor: There are also
significant cultural differences in how people use the medical information
they get.
Factoring usefulness into the communications equation has broad
implications for healthcare and the health profession, Duke researchers
write in the latest issue of the N.C. Med ical Journal.
Racial and ethnic minorities generally face more preventable illness
and death and a poorer quality of healthcare than whites, the researchers
note. So helping minorities overcome barriers to health and adopt healthy
behaviors means communicating with them through sources they view as
useful.
"Health care providers and public health practitioners have to con
sider how patients perceive various sources of medical information if
we're going to try to educate and empower people to eliminate healthcare
disparities," said Kevin A. Schulman, M.D., lead author on the study.
"Minorities' perceptions of information sources are important because
they are related to trust. Previous studies have shown connections
between race/ethnicity, trust, and interactions in medicine and medial
research."
The Duke study used information from a 2002 telephone survey of
515 Durham County residents 18 and older, divided roughly equally
among blacks. Latinos and whites. Among other questions, all were
asked about the usefulness of 12 sources of medical information. The
study was supported by a grant from The Duke Endowment.
The results showed that all the groups view doctors and nurses as
useful sources of information. But perceptions varied of other sources.
Black and Latinos surveyed tended to view ministers and churches,
community centers, health departments and television or radio as more
useful sources of information than whites did. Perceptions of print media
and the Internet didn't vary significantly, the survey found. Latinos were
less likely to report pharmacies as useful sources.
The pharmacy was perceived as useful by respondents who had
more education, and the health department was cited as useful by
respondents who were younger, less educated, less healthy, and unin
sured, the researchers reported. The odds of perceiving a minister,
church, or community center as a useful source of information were high
er for respondent s without a high school diploma and those who were
less wealthy, less healthy, and uninsured. Radio and television were seen
as more useful by respondents who had less education and poorer health
and those who were uninsured.
"If we want to send a message and are not using reliable media, then
the message isn't helpful," said Schulman, who directs the Center for
Clinical and Genetic Economics at the Duke Clinical Research Institute
and the health sector management program at Duke's Fuqua School of
Business. "An important part of public health involves health messaging
and social marketing."
Preventing health problems isn't just a medical challenge, because
people tend to practice self-care before turning to a doctor, he said.
That's where tailoring the right healthcare message comes in - from a
useful, credible source.
"Although there have been suggestions that we can reduce health
disparities by educating and empowering patients, there is little informa
tion on the effect of perceptions of the tools used to educate and
empower," the researchers note. "This study found persistent racial/eth
nic variation in perceptions of several sources of medical information."
In addition to Schulman, the study's authors were Kevin J. Anstrom
and Joelle Y. Friedman of Duke and Jason Williams, now of Stanford
University.
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