Researchers aimed to address the change in trust individuals exhibited regarding US physicians and hospitals during the COVID-19 pandemic.
Due to influencing factors such as declining vaccination rates and the politicization of public health, overall trust in physicians and hospitals decreased in the US from April 2020 through January 2024. Based on hundreds of thousands of responses to a 50-state survey aimed at representing the whole of the US population, researchers argued that the failing trust in public health must be restored.
“During the COVID-19 pandemic, medicine and public health more broadly became politicized, with the internet amplifying public figures and even physicians, encouraging individuals not to trust the advice of public health experts and scientists. As such, the pandemic may have represented a turning point in trust, with a profession previously seen as trustworthy increasingly subject to doubt,” wrote authors of a study published in JAMA Network Open.1
A perfect example of the politicization of public health and the amplification of physicians and public figures is represented in the following excerpt from a 2020 New Yorker article titled, “How Anthony Fauci Became America’s Doctor.” Barely 2 months into worldwide shutdowns stemming from the COVID-19 pandemic, this April 2020 article broke down Fauci’s rise to global familiarity amidst an unprecedented public health crisis.
“Just before midnight on March 22nd, the President of the United States prepared to tweet. Millions of Americans, in the hope of safeguarding their health and fighting the rapidly escalating spread of COVID-19, had already begun to follow the sober recommendation of Anthony S. Fauci, [MD], the country’s leading expert on infectious disease. Fauci had warned Americans to ‘hunker down significantly more than we as a country are doing.’ Donald Trump disagreed. ‘We cannot let the cure be worse than the problem itself,’ he tweeted,” according to Michael Specter of The New Yorker.2
Amidst a rapidly evolving political landscape in 2020—which was also an election year—the matter of the COVID-19 pandemic fell into place as a phenomenon that nearly split the political spectrum. Then, not long after Fauci’s initial rise to the world stage, the nation began to debate the efficacy of vaccines established to help reduce COVID-19 hospitalizations, keep the public safe from the disease, and get them back into society.
With vaccines existing at the forefront of the politicization of COVID-19, researchers aimed to understand the extent in which physician and hospital trust was associated with vaccination and vaccine booster behaviors.1 Alongside vaccine behavior, researchers observed participants’ self-reports of hospital and physician trust.
The survey study analyzed a total of 582,634 responses from 443,455 individual participants (mean age, 43.3 years; 65% women). When stratified by race, 71.1% of participants were White, 11.1% Black, and 8.7% Hispanic.
The overall change in hospital and physician trust decreased from 71.5% in April 2020 to 40.1% in January 2024. Accounting for a 31.4% decrease of patient trust in their institutions, the main indicators of lower trust were individuals 25 to 64 years old, women, lower education or income levels, Black participants, and those living in a rural area.1
“A lower level of trust was associated with decreased likelihood of vaccination against SARS-CoV-2 as well as influenza; these associations were not explained by political affiliation, nor fully accounted for by trust in science, suggesting some specificity for medicine per se. On the other hand, the change in trust during the pandemic may be specific to the US; prior studies suggested wide variation in levels of trust between countries before the pandemic, complicating any cross-national comparisons,” wrote the authors.1
From a distrust in vaccination prior to the pandemic to the inception of social media discourse regarding COVID-19, the change in trust for US hospitals and physicians cannot be attributed solely to the COVID-19 pandemic. Using prior studies, researchers stated that they cannot establish causation of the country’s decrease in trust, but they were sure to highlight how this 31.4% decrease could be detrimental to the public health of the US and its citizens.
“This survey study of US adults suggests that trust in physicians and hospitals decreased during the COVID-19 pandemic. As lower levels of trust were associated with lesser likelihood of pursuing vaccination, restoring trust may represent a public health imperative,” concluded authors of the study.1
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