Trust in Health: Why It Matters More Than Ever

by Jon Scaccia July 26, 2024

Trust is a big deal. Whether it’s trusting your doctor, the government, or even the information you read online, trust shapes our health decisions and, ultimately, our health outcomes. The COVID-19 pandemic highlighted this in stark terms. When trust is low, vaccine uptake drops, misinformation spreads, and public health efforts stumble. But what exactly is trust in health? How do we measure it, and more importantly, how do we build it?

A recent scientific review goes deep into these questions, providing essential insights that are especially relevant for public health practitioners.

The Many Faces of Trust

Trust isn’t just a single, simple idea. It has different forms and can be confusing. Here’s a quick guide:

• Trust: This is about being willing to be vulnerable, relying on someone or something when you’re not sure about the outcome.
• Mistrust: This means feeling uneasy or suspicious, believing that the trusted party might not meet expectations or might even harm you.
• Distrust: Similar to mistrust, but it usually focuses on specific entities, like a particular doctor or health institution.
• Trustworthiness: This is about the characteristics of the trusted party—being reliable, empathetic, and honest.

Understanding these nuances is crucial because they all affect how we interact with health systems and providers.

Trust and Health Outcomes: The Connection

Research shows that trust in health systems and providers can significantly impact health outcomes. For instance, people with higher trust levels are more likely to follow medical advice, take their medications, and attend follow-up appointments. On the flip side, mistrust can lead to poorer health outcomes, like missed screenings and lower adherence to treatment plans.

A poignant example from the review is how trust affected COVID-19 vaccine uptake. In communities where trust in public health systems was low, vaccination rates were also lower, leading to higher rates of infection and death.

The Roots of Trust Issues

Why do some people mistrust the health system? Historical and ongoing experiences of racism, marginalization, and other forms of oppression play a significant role. For many marginalized communities, there’s a long history of being treated unfairly or even harmed by health systems. These experiences create deep-seated mistrust that isn’t easily overcome.

Interestingly, the review points out that mistrust and distrust aren’t just about irrational fears or cultural beliefs. They’re often rational responses to real experiences of discrimination and injustice. This understanding shifts the focus from trying to fix people’s mistrust to addressing the behaviors and structures that cause it.

Building Trust: What Works?

The review suggests that building trust isn’t just about making people trust the system as it is. Instead, it’s about making the system more trustworthy. Here are some strategies:

• Transparency and Honesty: Health providers and systems need to be open about their practices, especially regarding mistakes or areas needing improvement.
• Community Engagement: Involving community members in health decisions and respecting their input can help build trust.
• Cultural Competence: Health providers should be trained to understand and respect the cultural backgrounds of the people they serve.
• Consistency and Reliability: Trust is built over time through consistent, reliable actions. Health systems must follow through on their promises.

Why Should You Care?

You might be wondering, “Why should I care about this?” Here are a few reasons:

1. Your Health Depends on It: Whether it’s getting vaccinated or following a treatment plan, your level of trust in health providers directly affects your health decisions and outcomes.
2. Community Health: Trust issues don’t just affect individuals; they impact whole communities. Low trust in health systems can lead to public health crises, as seen during the COVID-19 pandemic.
3. Equity and Justice: Addressing trust issues is a step toward greater health equity. Ensuring that everyone, regardless of their background, has fair access to trustworthy health care is crucial for a just society.

Questions for You

1. Have you ever felt mistrustful of a health provider or system? What experiences led to those feelings?
2. What changes do you think could make health systems more trustworthy in your community?

We’d love to hear your thoughts and experiences. Share in the comments or join the conversation on social media.

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