Date Approved


Embargo Period


Document Type


Degree Name

M.A. Clinical Psychology




College of Science & Mathematics


Roberta Dihoff, Ph.D.

Committee Member 1

Steven Brunwasser, Ph.D.

Committee Member 2

Georita M. Frierson, Ph.D.

Committee Member 3

Jonathan M. Lassiter, Ph.D.


U.S. healthcare system, Latinx patients, health disparities


Hispanic Americans--Medical care; Trust


Clinical Psychology


The Latino community's healthcare engagement continues to be a growing national concern (Velasco-Mondragon et al., 2016). Due to sociocultural circumstances and racial marginalization, Latinas experience disproportionate health disparities and inequalities that may be exacerbated by healthcare system distrust (HSD) (Hacker et al., 2015). Ethnic identity, an established protective factor in Latino culture, may contribute to healthcare system distrust (Ai et al., 2012). Additionally, immigration status has been shown to negatively influence Latino's healthcare experiences leading to HSD (Luque et al., 2018). The present study evaluated the influence of sociodemographic factors and ethnic identity on HSD among Latinas. Ethnic identity and education were hypothesized to mediate the paths of sociodemographic characteristics on HSD in a Latina women (N =158). Structural equation model path analyses were conducted to examine the casual paths of these factors on HSD. Results demonstrate a significant direct effect of ethnic identity and education on HSD. Significant indirect effect suggests a partial mediation of immigration on HSD via education. Ethnic identity was also found to mediate the relationship between education and HSD. Individuals with higher levels of ethnic identity had higher levels of healthcare distrust. Ethnic subgroup differences suggest cultural heterogeneity in health-related attitudes. Psychosocial factors, such ethnic identity and education level, may impact Latina women's trust in United States healthcare system which may inform culturally sensitive treatment.