Objectives <p>Middle-aged Black adults occupy a distinct generational position, having come of age during the legal desegregation of healthcare facilities, yet continuing to face persistent disparities in treatment and access. Despite growing evidence, limited research explores how intersectional factors such as age, income, and education influence perceived discrimination and medical mistrust in this population. This exploratory mixed-methods study aimed to: (1) examine the relationship between intersectional factors and medical mistrust, (2) identify between-group differences, and (3) qualitatively explore how perceived discrimination influences mistrust.</p> Methods <p>Black/African-American participants (<i>n</i> = 21; mean age = 51.9, SD = 6.96), predominantly female (85.7%), completed the Group-Based Medical Mistrust Survey (GBMMS). Semi-structured interviews were conducted to explore perceived discrimination. Quantitative analyses included descriptive statistics, correlations, and one-way ANOVA using SPSS V.29. Qualitative data were analyzed inductively to identify common themes.</p> Results <p>The mean GBMMS score was 3.41 (SD = 0.74). No significant correlations were found between intersectional factors and overall mistrust. However, income indicated significant between-group differences among two GBMMS subscales: Suspicion and Lack of Support from Providers. Five themes emerged from interviews, highlighting the nuanced role of discrimination in shaping mistrust. Although due to the small sample size, the findings are preliminary.</p> Conclusion <p>These results suggest income may influence specific dimensions of medical mistrust among middle-aged Black adults. Qualitative insights emphasize the complex relationship between discrimination and mistrust, underscoring the need for community-engaged research. Future studies should expand sample sizes and prioritize culturally responsive approaches to address mistrust and improve healthcare experiences.</p>