Poll Shows Barriers to Finding a Trusted Health Care Provider

CINCINNATI—A survey of adults in Ohio found that more than one in 10 said a lack of or type of health insurance had prevented them from finding a trusted health provider. The 2015 Ohio Health Issues Poll (OHIP), funded by Interact for Health, asked Ohio adults about possible barriers they might have experienced when seeking a health care provider they could trust: lack of health insurance, type of health insurance and race or ethnicity. 

"A patient who trusts his or her health care provider is more likely to seek necessary care, to follow the health care provider's advice, to take medications as prescribed and to return for follow-up visits," explains Greer Glazer, PhD. Glazer is associate vice president for health affairs, dean of the University of Cincinnati (UC) College of Nursing and also co-principal investigator at Urban Universities for HEALTH (UU HEALTH) at UC. Interact for Health worked with UU HEALTH to create questions about lack and type of insurance and race and ethnicity as barriers to finding a trusted health care provider. 

OHIP asked insured adults if either a lack of health insurance or type of health insurance had been a barrier to finding a trusted health care provider. Responses to these two questions were similar. In both cases, slightly more than one out of 10 people surveyed said that lack of (12 percent) or type of (13 percent) health insurance had prevented them from finding a trusted provider. 

These health insurance barriers were reported more frequently among certain groups in Ohio. "African-American adults reported these barriers twice as frequently as White adults," says Jennifer Chubinski, PhD, vice president, innovation and learning at Interact for Health. 

This barrier was also more commonly reported as income decreased: nearly three in 10 adults earning less than 138 percent of the Federal Poverty Level (FPL) reported these barriers, compared with fewer than two in 10 adults earning between 138 percent-200 percent FPL and fewer than one in 10 adults earning more than 200 percent FPL. 

Another possible barrier to trust in a patient-provider relationship is race or ethnicity. The 2015 OHIP asked "Has your race or ethnicity been a barrier for you or your family in finding a health care provider that you trust when you are sick or need advice about your health?"

Among all surveyed Ohio adults, fewer than one in 20 (4 percent) felt that their race or ethnicity had been a barrier to finding a trusted provider. There was no significant difference between the "yes" responses from African-American (5 percent) and White (3 percent) respondents. However, 7 percent of African-American adults replied "Don't Know" to this question, compared with zero White respondents. 

"To us, this may indicate a need for more health care providers from diverse racial and ethnic groups that reflect the population of patients we serve, as well as a need for current providers to learn to be more aware of their patients' cultural backgrounds," says Barbara Tobias, MD, medical director of the Health Collaborative, a board member of Interact for Health, and co-principal investigator at UU HEALTH. She is also a professor of family and community medicine at the UC College of Medicine.

Income level of those surveyed also produced a difference in the responses. "Ten percent of adults earning less than 138 percent FPL reported that race or ethnicity had been a barrier to finding a trusted provider, much higher than among adults earning between 138 percent-200 percent FPL (2 percent) or above 200 percent FPL (1 percent)," says Chubinski.  

Interact for Health is an independent foundation that serves 20 counties in Ohio, Kentucky and Indiana by promoting healthy living through grants, education, research, policy and engagement. More information about insurance, race and ethnicity as barriers to finding a trusted provider, and other topics, is available online at www.interactforhealth.org/ohio-health-issues-poll