Acculturation, resilience, and healthcare trust in migrant populations: an equity perspective

Background Trust in the doctor-patient relationship is crucial for treatment outcomes. Acculturation influences health literacy, attitudes toward medical authority, and communication preferences, while resilience may affect how trust develops. This study examines how acculturation and resilience interact to shape trust in physicians, informing culturally sensitive, patient-centered care. Methods Between October 2023 and January 2024, 375 patients were surveyed in a monocentric primary care study using an anonymous questionnaire on acculturation, resilience, trust in medical care and health-related perceptions. Results Among migrants, 47.9% were born in Germany; 80.8% had lived in Germany > 20 years. Acculturation was predominantly German, higher in women (M = 3.77 vs. 3.46) and younger respondents (M = 3.38 in 18–39 years, M = 3.42 in 40–59 years, and M = 2.75 in ≥ 60 years).Trust in physicians was high overall, but lower in migrants (M = 2.94 vs. 3.03) and younger adults (M = 2.90 in participants aged 20–39 years vs. M = 3.25 in those aged ≥ 60 years). Resilience was almost even across gender (M = 3.63–3.64), slightly lower in migrants (M = 3.48 vs. 3.66), and increased with age (M = 3.55 in 20–39 years, M = 3.60 in 40–59 years, and M = 3.78 in ≥ 60 years). Logistic regression showed no predictive link between resilience and migration status ( p = 0.913). Conclusion Acculturation proved to be a key factor influencing trust in doctors and mental stability, with women and younger patients showing higher levels of integration. Resilience also acted as a protective factor against acculturation stress and increased with age. Differences in trust indicate unequal access to culturally responsive care, highlighting the importance of linguistic integration and patient-centered communication. Trial registration Not applicable, as this study was an observational, crosssectional survey without any interventional component and therefore did not meet criteria for trial registration.