This Is AuburnElectronic Theses and Dissertations

The Relationship of Trust in the Health Care System and Perceived Hope to the Quality of Life Satisfaction Among Adults in Alabama’s Expanded Black Belt




Lett, Debra

Type of Degree



Education Foundation, Leadership, and Technology


This quantitative study explored the quality of life in a historically depressed area in Alabama’s Black Belt where trust in the health care system has been challenged secondary to a landmark sentinel event altering the use of the healthcare marketplace, the agency and agenetic paradigms of the residents. The United States Public Health Service (USPHS) Study of Untreated Syphilis on the Negro Male commands new and historical rhetoric, the significance and impact of racism in medicine, mistrust of the health care system and the impact of these phenomena on the agency of minority members of society. The Black male in the 21st century continues a historical and long standing struggle in the health care marketplace, having the shortest lifespan of any gender among all races in the United States (U.S) of major race groups, which influences the accrual of gaining an adequate education impacting negative conjectures of socioeconomics, the accrual of social and human capital, which can and often evokes his critical presence in the criminal justice system. Trust is paramount for positive agency in all realms of social relationships, inclusive of health care. The operationalization of positive or negative hope can impact the quality of life for residents in a depressed system in the Deep South, with a historical legacy of racism and medical mistreatment. Data analyses implicate mistrust as significant in the faith based community from which the sample were derived. Findings from the study have the potential to help formulate future intervention models to promote a more positive trusting relationship with the health care system. The essence of the dialogue which continues in the 21st century, significantly questions the healthcare agency of people of minority status and the perpetual, cyclic and multigenerational processes influencing the continuation of inequities associated with health and the resulting health care and health disparities.