Discrimination, trust, and withholding information from providers: Implications for missing data and inequity

Area of Science:

• Health Services Research
• Patient-Provider Communication
• Health Equity

Background:

• Quality healthcare relies on open patient-provider communication and accurate data.
• Incomplete patient data can bias clinical decision support tools and precision medicine.
• Patient trust and comfort in disclosing information are crucial for data completeness.

Purpose of the Study:

• To assess the relationship between patient experiences of discrimination and withholding information from healthcare providers.
• To examine how different types of patient trust relate to information non-disclosure.
• To investigate the association between specific forms of discrimination and patient non-disclosure.

Main Methods:

• Nationally representative survey of US adults (n=2,029).
• Weighted logistic regression modeling to analyze relationships.
• Analysis of discrimination based on race, education/income, weight, gender, and age.

Main Results:

• Experiences of discrimination significantly increased the likelihood of withholding information (OR 3.7).
• Low trust in provider conflict of interest disclosure and responsible data use were linked to non-disclosure.
• All five common types of discrimination analyzed were significantly associated with patients withholding information.

Conclusions:

• Patient experiences of discrimination and specific types of distrust meaningfully reduce willingness to share health information.
• Systematic data missingness due to non-disclosure disproportionately disadvantages patients who experience discrimination.
• Addressing discrimination and building patient trust are essential for improving data quality and equitable healthcare outcomes.