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Primary Submission Category: Mental health/function
Associations of Violence Exposure and Psychological Traumatization with Healthcare and Police Trust
Authors: Nisha Sen-Gupta, Hannah Hamilton, Elizabeth Tung, Joyce Yang,
Presenting Author: Nisha Sen-Gupta*
Objective: To examine associations between violence exposures, psychological traumatization, and institutional trust, focusing on healthcare and police systems.
Study Setting and Design: Cross-sectional survey data were collected from 504 adult primary care patients between June and December 2018. Clinics were located in two epicenters of violent crime in Chicago, Illinois.
Data Sources and Analytic Sample: We measured violence exposure using the Brief Trauma Questionnaire (BTQ), which distinguishes between having any exposure to violence versus traumatizing exposure to violence; we additionally analyzed traumatizing exposure in combination with a positive screen for Post-Traumatic Stress Disorder using the Primary Care PTSD screener. We modeled three exposure types (community violence, police violence, police stops) as independent functions of healthcare and police trust, adjusting for sociodemographic characteristics. Healthcare trust was measured via the Healthcare Relationship Trust Scale (11-55 points) and police trust was binary (no confidence vs. some or more confidence).
Principal Findings: In a sample of predominantly middle-aged and older Black adults, we found that exposures to traumatizing community violence or a traumatizing police stop (with or without PTSD) were associated with lower healthcare trust within the respectful communication domain. By contrast, non-traumatizing exposures were not associated with lower healthcare trust. Our study also demonstrated that all traumatizing police-related exposure types (both with or without PTSD), as well as police stops in general, were associated with lower police trust.
Conclusions: Our findings raise concern that psychological traumatization could be a key contributor to lower healthcare and police trust among patients in lower-income and racially minoritized urban communities with exposure to violence.
Keywords: community violence, traumatization, post-traumatic stress disorder, healthcare trust, police