US public health institutions must rebuild public trust, University of Idaho research finds


If public health institutions want Americans to follow their example, they will have to work to build public trust, suggests a study by researchers in Idaho.

An article about the study was published in May in the journal PLOS One. The study was a collaboration between eight researchers from the University of Idaho and a researcher from the University of Texas-Austin.

“Most importantly, our research suggests that cultivating trust in the authorities responsible for communicating public health information would be the optimal way to increase (health-protecting behaviors) to slow the spread of future pandemics,” the researchers wrote in the item.

They surveyed 1,034 households in Idaho, Texas and Vermont between October and December 2020. At that time, vaccines for COVID-19 were not yet widely available. Public health officials have recommended and continue to recommend non-pharmaceutical methods to protect against the virus, such as masking and social distancing. But a handful of groups in Idaho and elsewhere have protested the mask mandates and other public health orders and guidelines. Meanwhile, a wave of COVID-19 has overwhelmed hospitals across the United States and nearly forced Idaho’s health care system to adopt a last-resort triage protocol.

The study found that Americans at the time were making choices to reduce their risk of perceived threat. The more they trusted public health authorities, the more likely they were to accurately judge their health risk and take steps to protect themselves from illness, the researchers wrote.

People in rural areas trusted the government less and saw COVID-19 as a lower health risk; those in urban areas had more trust in institutions and thought COVID-19 was more of a health risk.

“On average, rural Americans are older, more likely to live in poverty, have higher rates of chronic disease and disability, and are less likely to be insured than urban dwellers,” the authors wrote. researchers.

The trust deficit they identified “creates additional vulnerabilities to COVID-19 in rural communities”, they wrote.

The survey also asked people about the perceived threat of economic risk and risk to the community versus the individual. Several questions asked about a person’s own behavior in contexts where the people around them follow or do not follow public health recommendations; for example, if no one in a grocery store wore a mask, would they?

The findings echo similar research conducted before the coronavirus pandemic.

“For example, during the 2009 H1N1 (aka ‘swine flu’) outbreak, people who said they had less trust in government were less likely to take the vaccine, which resulted in a large amount of unused vaccine,” wrote a group of researchers. in an article also published in PLOS One, in 2017. “Additionally, in a study of HPV vaccine acceptance, mothers who reported having high trust in the government were more likely to accept the vaccine. “

Throughout the current pandemic, individuals and groups have been spreading false and misleading information about coronavirus vaccines and treatments. In Idaho, some of these people have been elected or members of public health boards.

“In the case of COVID-19, trust in the message and the messenger was undermined by several factors,” the University of Idaho researchers wrote in their May journal article. “Namely, there was a lack of uniform national, state and local strategies; inadequate scope, accessibility and consistency of public health information; and widespread misinformation and disinformation that has not been sufficiently refuted. Studies suggest that misinformation not only erodes trust in public health authorities, but also decreases motivation to seek out and adopt correct information.

Government leaders and health authorities have changed their recommendations several times during the pandemic, often in response to new findings, changing threat levels, and new drugs and vaccines. But federal public health agencies — particularly the Centers for Disease Control and Prevention — have drawn criticism and mistrust from all quarters: from health experts concerned about COVID-19, to anti-vaccination activists who play down the risks of COVID-19, to members of the general public.

“The main driver of how people act is what they perceive to be a risk to their health,” said Benjamin Ridenhour, professor of mathematics at the University of Idaho and lead author of the research paper, in a press release on the study. “One way people determine that is by what the government tells them. It is therefore important to have a clear message.

The study added to existing evidence that pandemic-related behaviors align with political ideology. But more than politics, trust in healthcare facilities had the greatest influence on a person’s perception of risk.

The study was funded by a grant from the National Institute of General Medical Sciences.


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