Date of Award


Degree Name

Doctor of Philosophy




Michael A. Zaráte


A large body of literature has identified significant racial and ethnic disparities in health care and health outcomes. In an effort to gain an understanding of how to achieve health equity, it is crucial that we broaden our search for factors beyond access factors that may explain these observed disparities. The present study examined how cultural differences related to attention (context vs. focal) and attribution (internal vs. external) influence individuals' propensity to identify symptoms as potential markers of poor health, and ultimately, report less utilization of professional health care services. Using a community sample of 252 (n = 134 Latinos and n = 118 non-Latino Whites) adult community members from the El Paso region, we tested a model in which people's attentional orientation toward context is related to lower utilization of professional health care services. This is because attentional orientation toward context encourages people to attribute symptoms of illness to external/environmental factor and attributing symptoms of illness to external/environmental factors is associated with less utilization of professional health care services. Results demonstrated partial support for ethnic differences in the measures of attention and attribution. Differences in health care utilization between Latinos and Whites were partially attributable to differences in attributional biases. Inconsistent with predictions, external symptom attributional bias did not mediate the association between contextual attentional bias and health care utilization.




Received from ProQuest

File Size

85 pages

File Format


Rights Holder

Sandra L Oviedo Ramirez

Included in

Psychology Commons