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Key points
- Americans distrust government institutions at a higher rate now than in the past.
- This means many Americans do not trust the guidance of government health agencies.
- But high trust in physicians suggests a more complex picture than we think.
It stands to reason that an important component of a functioning society is the population’s trust in government and public institutions. This trust is especially important in a democratic society, where citizens need to have faith in and feel supported by their public representatives in order to feel that there’s a point to participating in civic responsibilities, such as voting. Without trust, there can be no reliable and open communication and basically no way for the government to inform and guide people through sometimes difficult situations and decisions.
Even before the COVID-19 pandemic, there was evidence that Americans’ trust in government was declining. A Pew Center poll from 2019 found that, in addition to Americans’ declining trust in government and each other, 64 percent of citizens believed that the declining trust in government made solving the country’s problems harder and 70 percent said that declining trust in fellow citizens made this kind of problem-solving more difficult. There is reason to believe that trust in government, both federal and local, has further decreased during the pandemic.
Is this distrust in government a symptom of a larger societal distrust in all authority figures? One arena where this trust issue has come up frequently in recent years is in medicine and health. It has been assumed of late that Americans’ trust in doctors, the healthcare system, and public health officials is at an all-time low. Given common refrains we hear from people about their confusion about various COVID-19 guidelines and outrage over various restrictions, it seems only logical that trust in public health would be extremely low.
However, some forthcoming research conducted by our organization, Critica, suggests that this is not quite the case. While it is true that people hold a lot of suspicious views, especially about government agencies, government health officials such as Dr. Anthony Fauci, and pharmaceutical companies, people still overwhelmingly trust and turn to their personal physicians and other healthcare providers for advice. When asked about to whom they would turn for information both on the COVID-19 vaccine and on the flu vaccine, an overwhelming majority of focus group participants in our study said that they would first and foremost ask their personal or family physician. Many also commented that for information on childhood vaccines, they would first go to their child’s pediatrician. While most of these people also said they would consult the internet, it was rare for anyone to list the internet as their sole source of information. When a friend or family member was a primary source of information or advice, it was almost always because this person was a healthcare worker.
These findings suggest that the issue of trust in physicians and health officials is much more nuanced than we might think. While it is true that people overwhelmingly cited their personal physicians as their primary source of information on all things health-related, they would also often spout out what could almost be characterized as conspiracy theories in the same breath. Many people simultaneously believed their doctors were trustworthy while also stating that they thought that vaccine manufacturers and pharmaceutical companies more generally had corrupted doctors and the healthcare system and that they were deeply suspicious of the whole operation. How can a person simultaneously mistrust the healthcare system and even physicians writ large but also trust their own personal physician more than anyone else for essential decisions about their health and safety? While we need more research to be able to answer that question it is worth recognizing that people probably do not always carry over beliefs about large systems to their interactions with individuals.
While it may seem dissonant, it is actually quite common for people to distrust “doctors” as an entity but still place an enormous amount of trust in their personal physician. This is important because it allows us to more accurately explore the actual impacts of conspiratorial or distrustful thinking on people’s day-to-day decision-making, that is, it seems possible for someone to hold conspiratorial thoughts but still trust an individual in the class they have suspicions about. Another important insight is that this research generated is that it gives us a window to intervene in conspiratorial or distrustful thinking by helping people recognize that there are people they trust, even within a category of people they claim to entirely distrust. Perhaps most importantly, it allows us to have hope that our healthcare system might be able to regain people’s trust.
